Treatment of Mirena (Hormonal Iud)
Pap Smear Procedure
Dilatation And Curettage (D C) Procedure
Proton Therapy Treatment
Preimplantation Genetic Diagnosis (Pgd)
Pregnant Women Counseling
Prenatal And Birth Care
Musculoskeletal Pain Management
Ovarian Ablation Procedure
Treatment Of Female Sexual Problems
Egg Donation Procedure
Treatment Of Menstrual Problems
Treatment Of Menopause Related Issues
Treatment of Polycystic Ovary Syndrome In Adolesce
Pre And Post Delivery Care
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Patient Review Highlights
Dr. Garima Kaur provides answers that are very helpful. Thank you doctor
Hypertension during pregnancy can be a problem for both baby and the mother. Thus it is of utmost importance that during pregnancy a good health should be maintained along with controlled blood pressure and cholesterol levels. With an increase in multiple births and women of older age the risk of hypertension during pregnancy has increased. But if proper care is taken it can be avoided.
Types of Pregnancy Hypertension:
There are three prominent forms of hypertension that can be seen during pregnancy. The pregnant ladies should be aware of the same. These are:
- Preeclampsia: This is the most common and serious hypertension during pregnancy. This hypertension can only be controlled by delivering the fetus, which usually involves complications like death of the mother or child. This occurs 20 weeks after pregnancy.
- Gestational hypertension: This form is only prevalent during pregnancy and is not a problem for the mother or baby after delivery. This usually occurs in the last leg of the pregnancy
- Chronic hypertension: This form forms either prior to the pregnancy or before 20 weeks of the pregnancy.
Management of Pregnancy Hypertension:
Hypertension during pregnancy can be handled by the following:
- In case of severe hypertension, blood pressure medication should be continued during pregnancy.
- If you are on ACE inhibitor type medication, then the medication is changed to one that is even safe for the baby.
- Your doctor might like to monitor you daily and can advise hospitalization for a few days
- If medication is missed, it might lead to uncontrolled life threatening hypertension. Thus the medication should not be missed at any time.
- In case of mild hypertension and absence of other diseases like diabetes and kidney disorders, the doctor might stop the medication or reduce the dose. Also, being off medicine does not cause any problem in mild hypertension.
- Irrespective of the hypertension being mild or severe, the prenatal appointments should not be missed, so that the doctor can monitor you and the baby. So that problems, like rise in blood pressure, poor fetal growth, and signs of preeclampsia can be spotted and steps can be taken for the same.
- In case there is some form of hypertension present the prenatal visits and lab tests will be more.
- Apart from the usual second trimester ultrasound, there will be periodic ultrasounds in the third trimester to monitor the baby's growth and the amniotic fluid.
- Also regular fetal tests and Doppler ultrasounds will be done to track the baby's growth.
- Lifestyle changes should be made. Salt intake should be limited, fresh food instead of processed food should be consumed.
- If blood pressure is high then doctor might ask you to avoid exercise especially if you never did before pregnancy.
To stay in shape, you are required to follow a fitness plan that’s different from men. And, to lose a lot of pounds one must go for running, cycling and any other cardio exercises. But there comes the point when the weight loss suddenly comes to a halt showing no results whatsoever and the woman who never missed her fitness classes is now losing interest in the ongoing fitness regime. In all such instances, strength training is the best way to ensure that fitness remains at beck and call and a 4-week fitness program is what all women must try in order to have a solid foundation of strength and maintain fitness throughout.
The 1st week
If a woman is not accustomed to the weight training exercises, it is natural to be overwhelmed by the idea. But weight training is not as difficult as it may appear to be. One shall have to complete each workout like the straight sets. For instance, it is recommended to do a set of leg presses, then proceed on to the next set of the workout. All the workouts must be completed in this manner with 12 repetitions for 3 sets and a rest of 30 seconds in between. The fitness experts suggest selecting a weight load where the final two repetitions of the set are harder to perform and don’t let the woman do a 13th repetition. One can also increase the load of weight for each set while sticking to 12 repetitions for all the three sets.
The 2nd week
One shall continue with the straight set format for all the workouts in the 2nd week as well. But the 12 repetitions must be increased to 15 with 15 seconds of rest in between. This means that the 2nd week of the fitness regime allows the woman to complete more movements in less time. The fitness training is a wonderful stimulus of taking the exercise regime to the next level.
The 3rd week
The 3rd week is the juncture of the fitness regime and is extremely crucial for a thorough weight loss. In place of the straight sets, one would have to perform the circuit sets. One shall have to complete a set of each movement in 15 repetitions and then instantly move to the next movement without any rest in between. For instance, if someone is performing leg presses, then it has to be done for 15 reps and then move to the following movement such as goblet squat with no rest. After the completion of all the movements, the circuit has to be performed twice.
The final week
The circuit set style would remain unchanged in this week, and the woman shall only have to perform 12 repetitions of each movement. But it gets harder in this week as in it is recommended to do 4 complete circuits without any rest in between. This week must be dedicated to keeping oneself moving, and once a movement is finished, one shall have to instantly return to the first movement to begin a new circuit. If you wish to discuss about any specific problem, you can consult a gynaecologist.
Hysterectomy is a procedure that is used to treat a wide variety of conditions. A partial hysterectomy is performed for the removal of the uterus whereas a myomectomy is performed for the removal of the fibroids. A complete hysterectomy is performed in order to remove the uterus and the cervix. With hysterectomy, there comes some critical and sensitive topic that needs to be discussed with the surgeon. Here is a list of top 10 things that need to be known about hysterectomy:
- The sex life concern: Unlike common apprehension, hysterectomy doesn’t necessarily mean the end of sex life. In the worst case scenario where the cervix is removed, it takes around 6 weeks before one can resume the sex life.
- Hysterectomy can’t cure endometriosis: Endometriosis is a condition that is characterised by menstrual cramp, painful intercourse and chronic pain. Hysterectomy is not the first line of treatment for a condition like this. If any doctor has suggested it, it makes sense to take a second opinion.
- Hysterectomy doesn’t mean menopause: This procedure doesn’t mean a menopause or an inability to get pregnant. There are certain other misconceptions such as getting night sweats, hot flashes and menstrual cramp etc. On the contrary, a well-performed procedure will ensure that a person doesn’t feel a thing after the surgery.
- The loss in ovaries: Depending on the condition of a patient, a doctor might remove the fallopian tube, uterus and ovaries. It necessarily means a sudden loss of oestrogen and progesterone hormone abruptly. Both this hormone are critical for bone and sexual health. It might also lead to menopause, decreased urge in sex and hot flashes during the night. It is therefore very important to discuss each and every aspect of the procedure before the surgery begins.
- Hormonal therapy: Since the removal of ovaries is likely to cause physical discomfort to the body, hormonal therapy can come to the rescue of an individual. Hormonal therapy can curtail the risk of blood clot formation, heart diseases, stroke etc.
- Explore other non-surgical options: Hysterectomy is not the last word for any uterus or ovary related problems. The goal is to keep the uterus intact. There are certain less evasive procedures to save ovaries and uterus. This is where multiple opinions come handy.
- Less invasive options: There exist less invasive surgeries for treatment related to uterus and ovaries. For instance, a robotic hysterectomy causes far less pain as compared to traditional procedure. It also ensures less loss of blood from the system resulting in less weakness.
- The morcellation technique: In case a uterus has to be removed, doctors these days use a process known as morcellation. The latter involves making small cuts into various places of the uterus in order to bring it out. The false apprehension of this process causing cancer cells in the body is not true. Only if a patient is suffering from a particular kind of cancer, it might spread to other parts of the body. A doctor has to be consulted to assure such a thing doesn’t happen.
- Cancer apprehension: For people facing a gene defect such as BRAC1 and BRAC2 hysterectomy can reduce the chance of ovarian cancer by a good 80 percent.
- Physiological healing post hysterectomy: Although physical healing takes no more than 6 weeks after the procedure, the emotional healing might take some time. It makes sense to seek professional help for postoperative depression.
Artificial insemination is a form of artificial fertility procedure. This procedure enables a couple to conceive a child. This procedure is mainly used in cases when the male partner has a low sperm count or is impotent. Single women who do not have a partner too can undergo this procedure to have a child. The process of artificial insemination involves the placing of sperm into the uterus of a woman, during the ovulation period.
Although artificial insemination is an effective procedure for conceiving a child, it also causes several side effects on the body and health.
Here are the several risks and side effects of artificial insemination:
- Infections are likely after having an artificial insemination done and infections are likely in a large percentage of women who undergo this procedure.
- Allergies can also possibly develop to any component of the seminal lavage, although they are not very common.
- Immune reactions can also occur, which involve the creation of antisperm antibodies among women who undergo this fertility procedure.
- Pain is felt by some women during the process of artificial insemination, and discomfort is also experienced when the catheter gets inserted in the cervix for transportation of sperm.
Risks regarding ovarian stimulation
- Ovarian hyperstimulation syndrome or OHSS may occur as a side effect of artificial insemination. This disorder makes the ovaries feel pain as they become swollen.
- Multiple births is another severe side effect of this procedure. It usually occurs in 12 to 30% of women undergoing artificial insemination. It is more likely in young women having more than five ovarian follicles, which are quite large. This occurs when the woman is inseminated with more than thirty million sperms.
Artificial insemination has several side effects, which may cause complications in pregnancy. They are as follows:
- Miscarriage can occur in women who undergo artificial insemination and occurs in 20% of all artificial insemination cases. The miscarriage is usually caused during the early phase of the pregnancy.
- Ectopic pregnancy is another side effect of artificial insemination involving pregnancy complications. Around 4/100 of women who undergo artificial insemination suffer from ectopic pregnancy. The rate of ectopic pregnancy in natural insemination is much lesser.
Artificial insemination is a successful process of conceiving a child. This procedure is utilized by single women and women whose partners are not capable of producing sufficient sperms. However, the process is associated with several side effects and risks.
What is erythroblastosis fetalis?
Erythroblastosis fetalis is also known as haemolytic anaemia in the newborn. This occurs due to blood incompatibility in the mother and foetus. Due to this incompatibility, the antibodies present in the mother’s blood, will pass through the placental barrier and attack the blood cells of the foetus. This will lead to the destruction of the red blood cells of the foetus and it is likely to cause anaemia in the foetus. This condition varies from mild to very serious. In its moderate or severe stage, the erythroblasts or immature red blood cells are formed in the blood of the foetus and this disease is called erythroblastosis fetalis.
Why does it happen?
The two main causes of erythroblastosis fetalis are Rh incompatibility and ABO incompatibility.
- Rh Incompatibility: When the mother is Rh –ve and the father is Rh +ve, there is a good chance for the baby to be Rh +ve. The antigens present in the blood of the Rh +ve baby will behave like a foreign agent and the mother will produce antibodies against it. If it is the first pregnancy, then the child may not be at risk, however, if the second child ends up being of +ve blood group again, then the antibodies present in the mother’s blood will attack the baby and may result in a spontaneous abortion.
- ABO Incompatibility: This usually occurs when the mother’s blood group A, B, O does not match the baby’s. This causes fewer complications in comparison to Rh incompatibility, but it may be severe if the child has a very rare blood group.
How to avoid it?
It is a highly preventive condition. Firstly, you have not tested your blood group; it is advised to get it tested along with the blood group of the father. If you already know your blood group, then you must mention it to your doctor. If the father has negative blood group, then there will be no problem. However if the father is Rh positive, then it is advised to get routine tests done by the doctor.
The other preventive measure to take is a treatment called RhoGAM or the Rh immunoglobulin. It reduces the reaction of the mother to the baby’s blood cells. This shot is administered around the 28th week of the pregnancy. It is also administered 72 hours after the birth of the baby with the positive blood group. If you wish to discuss about any specific problem, you can consult a pediatrician.
Most women stay confused with the time of their ovulation. Couples who are sexually healthy and are in their 20s and 30s and are not using any birth control measures have 20% chances of getting pregnant. It is interesting to know that you have a high chance of getting pregnant at the time of ovulation. It is a small window period that comes each month. It is the time when your ovary produces ovum or egg and the egg is open for fertilisation. Even if you are having sex two or three days before ovulation, there is a high possibility of fertilisation. After ovulation is over, the window period gets shut for the next cycle. It is the safe period. Though doctors say that it cannot be considered 100% safe to have unprotected sex during this period, the chances of getting pregnant are considerably lower.
When does ovulation actually start?
It should be remembered that ovulation takes place at the middle of your menstrual cycle. It usually occurs halfway through the cycle. Commonly, the average time period of a cycle is 28 days. But, in some cases, women may have cycles as long as 23 to 35 days.
How will you know that you are ovulating?
- Check your calendar: It is a healthy habit to keep a menstrual calendar. You must maintain the dates for a few months. This will give you an idea as to when you actually ovulate.It is difficult to know the actual time of ovulation if you are having irregular periods.
- Carefully listen to your body: It is a common thing that your body spontaneously sends a memo to you before ovulation starts. You get cramps or feel pain in the lower abdomen before ovulation starts. This pain is called mittelschmerz. It is a reminder of the coming periods.
- Chart your body temperature: Well, you will need to keep a record of your basal body temperature. You can measure it after three to five hours of sleep. Your basal body temperature changes throughout the monthly ovulation cycle. Progesterone hormone is responsible for the increase in body temperature. In the first half of the month, the progesterone levels are low and hence the temperature remains low as compared to the second half of ovulation.
- You can go for saliva test: Your saliva contains the estrogen hormone. Its level changes throughout the cycle. You can also use an ovulation detector kit to know the dates. If you wish to discuss about any specific problem, you can consult a doctor and ask a free question.
PMS or premenstrual syndrome affects women exactly prior to their menstrual cycle. This syndrome may have affects manifold, impacting a woman’s physical health, behavior and emotions. The condition is very common and affects more than 80% of the women before their monthly cycles begin.
The exact cause of PMS is not yet ascertained. It is believed that changes in hormones in the body can lead to PMS. Before the menses start, progesterone and estrogen levels tend to dip in the body. This hormonal dip results in anxiety, anger and irritability issues. Levels of serotonin, a chemical in the brain which affects your moods and thoughts, in the body also decrease at this time. Here are certain factors which make you prone to PMS –
Family history of PMS
Being subject to domestic violence
Emotional and physical trauma
Past history of mood disorders
The menstrual cycle lasts for 28 days. On the 14th day, egg is released from the ovaries; this is known as ovulation. The bleeding or menstruation occurs on the 28th day of the cycle. Symptoms of PMS start to show up from around the 14th day of the cycle.
PMS includes signs such as abdominal cramps, bloating, acne and sudden craving for sweet foods. Stomach disorders such as constipation and diarrhea are also common. Mental disorders such as anxiety and mild depression have also been observed.
Managing PMS Symptoms-
With PMS, one can take these steps to deal with the various signs of discomfort. Here are some remedies to deal with PMS symptoms:
Eat a balanced diet consisting of fruits and vegetables to get Vitamins and minerals in the required amounts.
Keep yourself hydrated to ease symptoms of bloating.
Consuming supplements of folic acid, Vitamin D and calcium can help easing the symptoms.
Sleep for 6-8 hours on a regular basis.
Exercise regularly to beat stress and avoid bloating.
Try relaxation techniques to get rid of stress or at least limit stress levels.
Some pain killers can help combat the pain resulting from muscle aches.
Piercing is a form of body ornamentation. It involves the use of needles to pierce through the skin and attach a piece of jewellery to the skin. The purpose of piercing is to beautify and in case of genital piercing, it comes with the additional perks of sexual stimulation. However, this completely depends on individual preference. In the female genital anatomy, several parts are suitable for piercing. This includes the clitoral hood, the labia and the vulva vestibule.
How piercing should be done?
1. The skin around the area where the piercing is to be done must be cleaned with antiseptic.
2. A topical anaesthetic may be applied to temporarily numb the area to be pierced. This helps to control pain.
3. Any piercing must be carried out by a licensed, well-practised professional.
4. Piercing must be done with the use of new, unused, sterilized needles, which are easily disposable.
5. After-care must be provided immediately after the piercing. This includes the application of medicated healing creams, or an ice pack that relieves the pain of piercing. Typically a piercing should heal completely by the sixth week.
Risks associated with vaginal piercing
1. Wrong technique of piercing can lead to uncontrollable bleeding and wounds.
2. Poor placement of jewellery can cause the piercing to heal very slowly and painfully.
3. Poor sterilization of needles and unhygienic methods can cause severe skin infections and other complications.
4. Tearing of skin or sagging of the clitoral hood, or labia can occur due to the improper weight of the jewellery placed.
5. Spread of genital disease may occur if the piercer does not use gloves or antiseptic during the procedure.
Never opt for a piercing just because your friends are getting it done. A healthy method of getting pierced involves an understanding of your anatomy, skin type, tolerance of certain kinds of metal on your skin and extremely hygienic conditions. It sure is fashionable and may appeal to people with a different sense of aesthetics, but you must never ignore the risks. Do a thorough background check of the piercer you would like to visit and the possible after care products that you can use. It would also help to quickly get a check up done by a doctor before going ahead with the piercing. If you wish to discuss about any specific problem, you can consult a doctor and ask a free question.
Most women have their own distinct smell below the belt. It might be a little embarrassing to know that there is a feminine odor, sometimes foul, in the private parts of a lady. But, it is true that this smell can be a cause of concern as well. Vaginal odour is a symptom for sexually transmitted diseases like chlamydia and gonorrhea. Besides, a combination of factors including infection of the vaginal tract, unhygiene, gland secretions, sweating and improper clothing are responsible for vaginal odour.
Common reasons for vaginal odour:
- Bacterial vaginosis: It is a very common phenomenon. Vagina contains bacteria, which are produced there naturally. Bacterial vaginosis refers to bacterial overgrowth. It leads to vaginal odour. Most women experience this condition at least once during their lifetime, especially in the reproductive years. Though the exact cause behind its occurrence is unknown, it can occur due to having unprotected sex or frequent douching.
- Yeast Infection: The odour caused due to yeast infection is not very strong. But it has other symptoms like white vaginal discharge and itching. The discharge looks like cottage cheese and is caused due to the excess growth of yeast named Candida. There might be a burning sensation at the time of having sex or urination.
- Sexually transmitted diseases: Vaginal odour is a symptom for STDs like chlamydia and gonorrhea.
- Vaginal odour can intensify after having sex: It can also be caused due to inflammation of the pelvic region.
When is vaginal odour a signal for STDs?
Vaginal odour is normal, but you need to watch out for other symptoms to be sure that whether or not you are infected with STDs. If you have vaginal discharge, painful urination and difficulty in having sexual intercourse, there is a possibility of developing STDs. In case of STDs, the discharge is bloody or brown in colour.
The vagina is a muscular, tubular structure of the female genital tract extending from the vulva to the cervix (the opening of the urethra). Sexual activity affects vaginal health in a number of different ways during intercourse and in the long term.
A few of the varying effects and the factors responsible for these effects are listed below:
- Changing size of the vagina: The vagina is designed to be elastic and adjustable. So, no permanent change in size is possible but it does undergo temporary changes in sizes as effects of sex. The inner walls of the vagina enlarge during sexual intercourse and during childbirth. Tissues in the clitoris puff out and harden, this also causes an expansion in size. It takes a while to get back to its normal size.
- Vaginal secretion: When you are aroused during sex, the blood vessels supplying the vagina expand immediately. The blood flow increases to lubricate the vaginal walls (rugae). The rugae unfold and the space increases. These secretions are important because, women who are sexually inactive for a long time at a stretch, experience dryness that leads to urinating difficulties and rashes.
- Unusual discharge: Apart from natural lubricants, vagina secretes some fluids, the process being termed as 'female ejaculation'. A tiny amount of white fluid made of prostate plasma cells, is produced just before you climax and discharged with some quantity of urine. Sometimes, prostatic specific antigen (PSA) and prostatic acid phosphatase (usually found in semen) are also found in the secretion.
- Infections in the urinary tract: The friction caused by sexual intercourse may cause small cuts which enable bacteria to pass from the vagina to the urinary bladder through the urethra. This causes infection in the bladder, the urinary tract and the vagina. These can be avoided by using a condom or by urinating before and after having sex.
- Vaginal pain: A lot of women report the experience of pain and discomfort inside or around the vagina during and immediately after sex. The pain can result from repeated sex within a short period of time or reduced secretion of natural lubricants. If the pain is too severe, you should see a doctor because yeast infections or chronic vulvodynia can also be responsible for the pain sensation.
Fibroids are non-cancerous growth that develop in the uterus in varying sizes. Fibroids do not usually show symptoms, but if they are large they may cause severe pain in the abdomen, heavy menstrual bleeding, bloating, infertility or complications during pregnancy. Several factors may lead to the formation of fibroids, including hormones, family history, and pregnancy.
What is myomectomy?
Myomectomy is the surgical procedure which is used for removing fibroids from the uterus. It is a safe method that allows women to become pregnant in future. Gonadotropin-releasing hormone analogue therapy, performed before myomectomy helps in lowering the estrogen level and also controls anemia by stopping uterine bleeding. The different surgical methods for myomectomy include:
- Hysteroscopy, involving the insertion of a lighted viewing instrument into the uterus
- Laparoscopy, involving the insertion of a lighted viewing instrument and one or more incisions in the abdomen
- Laparotomy, involving a larger incision made in the abdomen
Why is the surgery performed?
Myomectomy treats fibroids while preserving the uterus. It is a viable option for those who have:
- Anemia which cannot be controlled with medicines
- Pain which cannot be tackled with medicines
- A fibroid that can cause infertility or increases the risk of miscarriages
How well does it work?
- Pregnancy: myomectomy is the only treatment for treating fibroids that improve your chances of having a baby. The method is effective for treating submucosal fibroid. A cesarean section is required for delivery after performing a myomectomy.
- Recurrence: recurrence of fibroids after myomectomy is really low. It is possible in rare cases, depending on what the original fibroid problem was. Large and numerous fibroids have a greater risk of recurrence.
Use of regular contraceptive methods like pills or condoms have most effectiveness with least side effects, but in the case of emergency, you can resort to ipill easily available on all chemists. Unplanned pregnancy is best detected at the earliest and managed.