Dealing with Dysmenorrhoea (Painful Periods)

Dysmenorrhoea is a medical condition where a woman has extremely painful periods. While menstruation is normal, it is very painful. This is caused by disorders like fibroids, pelvic inflammatory disease, adenomyosis, endometrial polyps, use of intrauterine contraceptive device or endometriosis. Many women assume that pain is normal and must be tolerated.

Few ways to deal with dysmenorrhoea are:

1. It’s Ok To Take Pain Relievers: To relieve the pain, simple analgesics like paracetamol and aspirin can be taken.

2. Anti-inflammatory Drugs Can Taken: Non-steroidal anti-inflammatory drugs are also prescribed to deal with dysmenorrhoea and most women are known to feel relief from the pain.

3. Fish Oils Capsules: Fish oil capsules which contain Omega 3 fatty Acids are also a good option to use when troubled with severe menstrual pain.

4. Prefer Light Diet: A few minor dietary changes can also help. Eating low fat vegetarian food especially on the days of the periods can prove to be helpful.

5. Avoid Sedentary Lifestyle: It is said that exercise can reduce the pain of dysmenorrhoea. Sedentary lifestyle is not good for the uterus region and it is advisable to indulge in regular exercises.

6. Use Heat Therapy: Heat therapy is a common and effective way to deal with dysmenorrhoea. Keeping a hot water bag on the region of the pain is known to soothe the pain and help relax the muscles.  

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Why Do Some Girls Have Extremely Painful Periods?

Why every 1 in 5 Women in India suffers from PCOS? (And what they need to know)

Polycystic ovarian syndrome (PCOS) is a medical condition related to a woman’s endocrine system. Generally, this disorder is characterised by an imbalance of the sex hormones (oestrogen and progesterone), which leads to the development of multiple small cysts in the ovaries. Symptoms of PCOS include acne, irregular menstrual cycle and depression to name a few.
The causes of PCOS have not been accurately identified so far, but researchers suggest that the following factors might contribute to the onset of the condition.

1. Increased amount of insulin secretion- Women suffering from insulin resistance may get PCOS as their body is not able to effectively use this insulin, which results in increased insulin secretion by the pancreas. This, in turn, triggers more androgen (male sex hormone) production in the ovaries, making it difficult for the ovaries to ovulate.

2. Lower inflammation levels- The white blood cells present in your body form resistance against infections through a response termed as inflammation. Women with lower inflammation levels are likelier to get PCOS as the decreased levels stimulate polycystic ovaries, thereby producing more androgens.

3. Genetic factor-  If you have a family history of PCOS, it’s highly probable that you may also get it as the disease is linked with your genes.

How To  Live with PCOS

PCOS comes with numerous side effects like acne, obesity, infertility, excessive facial or body hair among others. There are certain lifestyle changes, which you may consider to manage PCOS and minimise its side effects.

1. Change your diet - Opt for a low carbohydrate, low sugar diet to keep your insulin levels in control, as insulin is responsible for increasing the severity of PCOS symptoms. 

2. Try to maintain an ideal body weight - Obesity is known for worsening insulin resistance, and you can prevent this by regularly keeping your weight in check. You can practice some easy at-home exercise to reduce weight besides having a balanced diet.

3. Get yourself checked regularly - Visit a doctor and get yourself checked regularly for potential health risks as PCOS is often associated with increased chances of diabetes, heart diseases, certain forms of cancer, hypertension, and high LDL (bad) cholesterol levels.

4. Join a support group - Joining a PCOS support group will help you cope with your emotional difficulties, while helping you to live a better life by cultivating an optimistic outlook.

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Every 1 in 5 Women in India suffers from PCOS! Why? (And what they need to know)

Epithelial Ovarian Cancer is a condition in which malignant tumor emerges from the tissue lining in the outer surface of the ovary. Epithelial tumors are usually benign, but this form of malignancy has been found to be the most common type of ovarian cancer. Moreover, it cannot be diagnosed until in its advanced stage. Medical research shows that factors such as multiple pregnancies, delayed childbirth and early menarche seem to raise the risk of ovarian cancer, while dietary and environmental factors also play a significant role in it.

Symptoms
1. A majority of the patients have been observed to have extensive intra-abdominal growth.
2. They may experience discomfort or swelling of the abdominal region.
3. The feeling of being bloated, lack of appetite, unnatural weight alteration, dyspepsia, malaise, and urinary problems are frequently reported symptoms.
4. Patients also experience constipation and other gastrointestinal problems.

Treatment
The first step towards treatment of ovarian cancer is to diagnose the condition. A thorough pelvic examination (consisting of an examination of the vagina, uterus, ovaries, fallopian tubes, and cervix) will help to pin point any abnormality of the ovary. If the doctor notes nodularity, firmness or lack of tenderness during the examination, these can be taken as symptoms of malignancy of epithelial ovarian tumors. Ultrasound examination of the abdominal region will also help to locate abnormality in the tissues on the outer surface of the ovary. The next logical step towards treatment is getting a biopsy. During this procedure potentially malignant cells are removed and then diagnosed by a pathologist to conclude if the cells are cancerous or not. The process of removal is known as laparotomy.

Apart from a handful of stage one patients, most women with epithelial ovarian cancer receive chemotherapy. The standard treatment for this type of ovarian cancer is the surgical elimination of tumor. This includes total abdominal hysterectomy, a surgery in which the uterus and cervix is removed through an incision in the abdomen. Post surgical treatment consists of taxane-platinum chemotherapy. Patients with minimal residual cancer undergo external radiation therapy or intraperitoneal chemotherapy (radioactive liquid is channelled into the abdomen with the help of a catheter).

A lot of research has been done in this field and a variety of clinical trials are available for a patient, if he/she wishes to be a part of it. Leading methods are immunotherapy and targeted therapy are also available. Immunotherapy uses the immune system of the patient to battle cancer. Bodily substances or substances created in the lab are used to restore and boost the body s natural defence mechanisms against cancer. Targeted therapy, on the other hand, uses substances to identify the cancer and attack the malignant cells without jeopardizing non-cancerous cells.

Epithelial Ovarian Cancer - 4 Major Signs that Indicate it 

Ovarian cysts are a common development in many women. Cysts are sacs filled with fluid which are formed in the female ovaries. Most cysts are harmless and do not even show any symptoms. However, some cysts do show outward symptoms like heavy bleeding, clotting, nausea, vomiting, stomach pain during the menstrual cycle, and pain during sex.

If you feel any of the above-mentioned discomforts, it will be in your best interest to book an appointment with your gynaecologist and get a check-up done. Most cysts are manageable unless they are very severe. In fact, it is best that cysts come to light at the right time and are efficiently managed, unless they develop into severe issues in the future.

Management of cysts

Oftentimes, medical practitioners resort to what is called  watchful waiting .
At times, ovarian cysts disappear in a few months.
It is recommended to take a blood test and an ultrasound to see the progress of the cyst.
If you have already experienced menopause, then these tests are carried out every four months. This is because in such cases the risk of an ovarian cancer is at its highest and regular monitoring of the cyst is necessary.
Treatment of cysts
Ovarian cysts can be treated in their earlier stages. Here are some of the most popular treatments.

Laparoscopy is one of the most popular treatments. It is a surgery carried out under general anaesthesia. The tummy is cut to a radius of a key hole and a laparoscope is inserted. This helps the doctor to see the internal organs, which is then used to remove the cyst. This method is less painful and has a quick recovery time.
Laparotomy is the other method used for removing a cyst. In case the cyst is large, then one single large hole is made in the body to access the cyst. At times, the cyst and the ovaries are removed and sent for further laboratory inspection. This inspection is done to detect whether the samples are cancerous or not. This procedure is more complex than the previous one and might need the patient to stay in the hospital for a few days.
In case you have a cancerous cyst, then your reproductive part itself would have to be removed rendering you barren for your life.
Ovarian cyst is very much treatable and is best to be detected at an earlier stage for better and faster treatment. Thus, it is best to go for regular check-ups and report in case of any disturbing symptoms.

Ovarian Cysts - 3 Ways They Can Be Treated!

PCOS (Polycystic Ovary Syndrome) is a common disease of the endocrine system among women who have attained the reproductive age. Women with this condition generally have ovaries larger in size than the usual, containing small pockets of fluids, also termed follicles. These 'follicles' develop in each of the ovaries as diagnosed with the help of an ultrasound exam. Abnormal or extended menstrual cycles, unusual growth of hair and obesity are some of the common accompanying conditions associated with PCOS. This disorder can interfere with a woman's menstrual cycles, thus making pregnancy difficult. More so, this condition can also impact the way you look and if left untreated for long, can lead to underlying disorders such as diabetes and other cardio vascular diseases.

Causes of PCOS
1. Excessive Insulin secretion: Insulin is a hormone secreted by the pancreas, which allows the body cells to utilize the sugar; the most important energy store of your body. If you suffer from insulin resistance, your body's ability to utilize the insulin gets affected adversely. This forces the pancreas to secrete more insulin in order to keep up with the body's energy supply. This excess insulin might result in an increase in the production of androgen, which in turn, might interfere with the ovulation ability of the ovaries.
2. Low- level inflammation: Inflammation is the process by which your body's white blood cells fight infections. Studies reveal that women suffering from PCOS have a low level inflammation which acts as a catalyst in the production of androgens.
3. Can be hereditary: If you have someone in your family suffering from this syndrome, you might automatically be at a higher risk of developing this disorder.

Symptoms accompanying PCOS
1. Abnormal menstrual is the most commonly observed symptom. Women suffering from PCOS may have less than nine periods in an entire year and in some cases, even none. 
2. Excess secretion of male hormone, which is related to excess androgen production may result in symptoms, such as abnormal body and facial hair, acne and baldness, which is identical to that in men.
3. Unexplained increase in weight and difficulty losing it as well.
4. Another fairly noticeable symptom is depression.
5. Infertility

PCOS- Causes and Symptoms

Q1. What exactly is Laparoscopy?
Laparoscopy is an alternative to 'Open' surgery wherein the abdomen is opened by tiny 'key hole' incisions and surgery is done. 'Scopy' means the use of an endoscope or telescope to see inside the abdomen. This is attached to a camera and a light source and the inside of the abdomen is projected on to a monitor. The surgeon performs surgery looking at this screen. The surgeon makes a total of 2-4 small cuts on the abdomen ranging from half to 1 cm through which the telescope and other thin surgical instruments are passed into the abdomen. When the uterus is removed , known as hysterectomy, there is also a cut at the top of the vagina where the uterus is attached.
Q2. What kind of gynaecological surgeries can be performed by Laparoscopy?
Most surgeries done in gynaecology can now be performed by Laparoscopy and do not require the large incision as for open surgery. Laparoscopy can be done sometimes only for diagnosis and is called Diagnostic Laparoscopy, as in checking whether the tubes are open or not and to look for any causes of infertility or pain outside the uterus. In women who are unable to conceive, Diagnostic Laparoscopy is often combined with Hysteroscopy (endoscope inside the uterus, inserted from below, via the vagina). When laparoscopy is done to perform some surgical procedure inside the abdomen it is called Operative Laparoscopy. This may be for simple procedures like sterilization, minor adhesions, drilling ovaries; or for intermediate or major reasons like fibroids, endometriosis, removal of ovaries or tubes or both or removal of uterus, for staging of cancers or radical surgeries for cancer. However, about 5% of all surgeries including those for cancer or very large tumours may benefit from open surgery.
Q3. Why does an expert surgeon recommend Laparoscopy over Open Surgery?
Laparoscopic surgery has many advantages above open surgery: the incisions are much smaller (open surgery incisions are 8-10 cms long), therefore pain is much less; requirement for pain killers (which can have side-effects like sleepiness, impaired judgement) is lesser; hospital stay is shorter; complications fewer; requirement for blood transfusions infrequent; recovery in terms of physical, emotional and mental state is much better and quicker; return to work is faster with consequent lesser loss of working and earning days. Surgery with laparoscope is more precise because it is magnified view. Further vision is much better because it's like having your eye behind the structure because you can see with the telescope at places where the surgeon's eye cannot reach.
Q4. If the cuts on the abdomen are so small in Laparoscopic surgery, how do you remove the uterus or a large tumour from inside the abdomen?
Quite often if the tumour is not malignant and contains fluid, it is punctured to collapse it into a smaller size. If it is solid, it can be cut into smaller pieces inside the abdomen using a special instrument. The collapsed or cut structures can be removed gently through the 1 cm cut on the abdomen which may be increased a bit if required. After hysterectomy, the uterus can be removed easily from below, through the vagina.
Q5. Will there be much pain or discomfort after Laparoscopic Surgery?
There may be some pain and discomfort in lower abdomen for one day to few days after Laparoscopic surgery but this is much less as compared to open surgery because the incisions on the abdomen are much smaller and there is much less tissue handling inside the abdomen by fine instruments instead of rough, big, gloved hands which can cause tissue injury in open surgery. There may be some pain in the shoulder following laparoscopy. This is not serious and is due to the gas used in the surgery to make space for instruments.
Q6. When can I be discharged from hospital?
Following Diagnostic Laparoscopy or with simple Operative Laparoscopy you can expect to be discharged from hospital latest by the morning after surgery. In most other cases of intermediate or even major surgery, discharge is generally 1-2 days following the surgery unless there is some health issues prior to the surgery or any complication during the surgery. The complication rates for Laparoscopic surgery are not more than for open surgery and depend upon patient factors like anaemia, diabetes, obesity and skill of the surgeon.
Q7. When can I perform routine household activities or return to work after Laparoscopic Surgery?
Recovery after surgery depends upon many factors: presence of health problems before surgery; why the surgery is required; what surgery is being done; problems or complications of surgery, anaesthesia or blood transfusions. If all is well, one can perform routine household activities by 1 week, provided one doesn't feel tired. Although there may not be any harm, it may be unwise to be normally active within 48 hours of procedure. Following Diagnostic Laparoscopy or Operative Laparoscopy for simple procedures, one can return to work in 1 week. For other procedures, a 2-3 week off from work is reasonable. It depends on the type of work you are returning to. Avoid too rapid return to work if it is manually hard or requires standing for long durations of time. Sometimes a surgical procedure brings on a well needed rest and break from a lifetime of work. Mostly, when you return to work depends upon your own body and its signals of tiredness. You need to listen to those signals.


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