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Dr Puneet Singh's Clinic

Gynaecologist Clinic

D-49, Hauz Khas, Delhi Delhi
1 Doctor
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Dr Puneet Singh's Clinic Gynaecologist Clinic D-49, Hauz Khas, Delhi Delhi
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Our goal is to provide a compassionate professional environment to make your experience comfortable. Our staff is friendly, knowledgable and very helpful in addressing your health and fin......more
Our goal is to provide a compassionate professional environment to make your experience comfortable. Our staff is friendly, knowledgable and very helpful in addressing your health and financial concerns.
More about Dr Puneet Singh's Clinic
Dr Puneet Singh's Clinic is known for housing experienced Gynaecologists. Dr. Puneet Singh, a well-reputed Gynaecologist, practices in Delhi. Visit this medical health centre for Gynaecologists recommended by 105 patients.

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MON-SAT
10:00 AM - 08:00 PM

Location

D-49, Hauz Khas, Delhi
Hauz Khas Delhi, Delhi - 110016
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My tsh is 5.6 and i'm pregnant. My doctor has prescribed thyronorm 12.5 mg. If I take this medicine, do I have to continue it post pregnancy?

BHMS
Homeopath, Noida
My tsh is 5.6 and i'm pregnant. My doctor has prescribed thyronorm 12.5 mg. If I take this medicine, do I have to con...
It will depend on your tsh levels post pregnancy. Now take it n don’t miss. As it affects growth n development of foetus.
1 person found this helpful

I have 10 months old baby till now I didn't get my period if we intercourse daily is there any chance to get pregnant please suggest your answer.

BHMS
Homeopath, Noida
I have 10 months old baby till now I didn't get my period if we intercourse daily is there any chance to get pregnant...
Yes, there is a chance. You need to do a urine pregnancy test to know if you are already pregnant. If test is negative then you need to do tsh, cbc n blood sugar random at some lab. If it’s normal then go for ultrasound of abdomen consult online with details.
1 person found this helpful

I am 19 years old. I had taken ipill last month and got my periods early. This month I missed them so I took gynocare tablet. I got the periods. Should I continue taking the tablet or not. What should I do to get my cycle normal?

BHMS
Homeopath, Noida
I am 19 years old. I had taken ipill last month and got my periods early. This month I missed them so I took gynocare...
There is no fixed time in which one bleeds after taking ipill. Sometimes unexpected bleeding occurs more over it is not necessary. Next menstrual cycle can be early or delayed as side effects of the pill.

I am a 23 year old female and 7 months and 15 days pregnant. For what purpose optithik sildenafil citrate tablet is prescribed for me?(for vaginal use)

MBBS, MS - Obstetrics and Gynaecology
Gynaecologist, Chennai
hello rohini, sildenafil is recently being prescribed for promoting placental blood flow and improving growth of suspected IUGR babies

Can I swell or take into the mouth of vaginal water at the time of oral sex. It is advisable or my wife can swell or take into her mouth of mine penis water please clarify. Clarify in hindi if possible.

MBBS
Sexologist, Panchkula
It is better not to do these things as these can cause infection. Do normal vaginal sex to satisfy your partner and yourself and be happy.

Vulvodynia - Know Forms Of It!

MBBS, MD - Obstetrtics & Gynaecology, DNB (Obstetrics and Gynecology)
Gynaecologist, Pune
Vulvodynia - Know Forms Of It!

Vulvodynia refers to chronic pain in the vulva, a condition suffered by most women. Triggered generally by an unidentifiable cause, the pain was not considered as a real pain syndrome until of late. The ambiguity of the condition is such that many who do suffer from it fail to realize its complications.

There are primarily two types of Vulvodynia:

1. Generalized Vulvodynia: This is when the pain is all over the vulva, however, different parts may pain at different times. It may be a constant pain or may occur occasionally.

2. Vulvar vestibulitis syndrome: The pain is in the vestibule area or the entrance of the vagina is known as vulvar vestibulitis syndrome. This kind of pain mostly exhibits a burning sensation and is triggered even by a slight touch. During intercourse the pain manifolds to extreme severity.

Although the cause of Vulvodynia is not known, doctors suspect the following reasons to be the contributing factors:

1. Nerve injury
2. Heredity
3. Yeast infections
4. Sexual abuse in the past
5. Muscle Spasm
6. Hormonal changes

Symptoms

1. Burning sensations
2. Aching or soreness
3. Itching

Treatment

Nowell versed cure is available for Vulvodynia, although certain self-care treatments can bring relief. Among the many, you need to figure out which method suits you best and choose accordingly. To discern the best method, you might have to try various different combinations. At the same time, it is extremely important to educate yourself about Vulvodynia and have a thorough knowledge about what it is all about.  It is advisable that you maintain a record of the treatments which according to you suit you the most in order to avoid confusion. Some of the methods are given below:

1.  Avoid products which might act as potential irritants near the vulva.
2. Do not put much pressure on the vulva. Avoid activities which might exert direct pressure on it.
3. Whenever it pains, try to soothe the area by soaking it in lukewarm water or applying ice on it.
4. Use medications like lidocaine to relieve pain.
5. Certain exercises might also help relax the area.
6. Biofeedback also helps relax the vaginal muscles and bring some relief.

School Refusal - How Should Parents Administer It?

MBBS, MD - Psychiatry
Psychiatrist, Delhi
School Refusal - How Should Parents Administer It?

Blessed are the parents whose children enjoy going to schools. Some parents have to sweat it out to convince and cajole their kids into going to schools. Every morning brings in a new struggle. You will often come across kids who hate going to schools. From complaining of a headache to stomach aches, they will try everything under the sun to give the school a miss. With time, however, things get under control, much to the parent's relief.

The situation gets dicey when children continue to panic, get stressed out at the mere thought of going to school (for a longer duration of time). With time, things get more and more complicated. A situation as critical as this is known as School Refusal Behavior. School refusal can affect children, adolescents, and even teenagers.

Factors that trigger school refusal behavior:
School refusal in children may be an amalgamation of many factors:

  1. In some children, the problem may be due to ADHD (Attention Deficit Hyperactivity Disorder). It is a common behavioral disorder that affects many children and even teenagers. In ADHD, children find it a herculean task to concentrate or to pay attention in class. Needless to say, this affects a child's overall performance in class. The fear of getting rebuked and punished (by teachers) may trigger school refusal in such children.
  2. Many parents set unrealistic goals for their children. They want their children to be the best. What they fail to realize is that in doing so, they end up suffocating the kids. In a few extreme cases, the pressure to excel in academics grips them with an unknown fear. They start avoiding classes. They get panic attacks at the mention of schools.
  3. There are some menaces which can make life miserable. Being bullied in school (by classmates or seniors) is one such issue. As time progresses, the situation may get so unbearable that the child at the receiving end starts showing signs of school refusal.
  4. Children with undiagnosed and untreated depression, stress, and anxiety may show signs of school refusal. Such kids prefer to stay within themselves. They don't enjoy social gatherings or interacting with people much.
  5. Some children want to be with their parents all the time. Going to school would mean being away from parents. Thus, they look for excuses to avoid schools.

Symptoms:
The symptoms characteristic of school refusal behavior include

  1. Irritability, inflexibility, and anger.
  2. Nausea, headache, stomach ache, vomiting.
  3. Diarrhea
  4. The affected child may show signs of separation anxiety.
  5. Sleep disturbance.
  6. Tantrums in the morning. 

Diagnosis and Treatment:

School refusal needs to be dealt with as early as possible since the longer the child stays away from school, the more difficult it will become for him/her to return to school.

  1. The Screen for Child Anxiety Related Emotional Disorders (SCARED).
  2. The Children's Manifest Anxiety Scale.
  3. The Child Behavior Checklist.

Parents, physician, and school authorities should together chalk out a plan to deal with the situation.

  1. Cognitive therapy can produce fruitful results.
  2. Any student subjected to bullying should bring it to the notice of their parents and teachers.
  3. Parents should not pressurize their child to overperform.
  4. Consult an expert physician if your child shows any signs of stress and anxiety.

Bleeding Disorders - What Causes It?

MBBS, MS - Obstetrics & Gynaecology, Fellowship in Minimal Access Surgery, Post Graduate Diploma in Sonography (Obstetric- Gynae), Fellowship In Assisted Reproductive Technology
Gynaecologist, Jaipur
Bleeding Disorders - What Causes It?

Excess bleeding or menorrhagia is a common kind of abnormal bleeding occurring at the time of menstruation. Menorrhagia causes more blood loss which leads to anaemia. Fatigue and breathlessness are common symptoms of anaemia.

Symptoms of excess bleeding

A few of the common symptoms of excessive bleeding are: 

  1. Discharge of large blood clots is a sign of heavy bleeding 
  2. Bleeding during the night which causes disruption in sleep as one has to wake up several times in the night to change the sanitary napkin 
  3. Menstruation lasts longer than usual or more than 5 to 7 days. 
  4. Any menses requiring an excess change of pads than usual 

Causes of excess bleeding 

  1. Imbalance of hormones: During adolescence and when nearing menopause, the female body undergoes some imbalance in oestrogen and progesterone hormones. At these points of time, heavy bleeding is common among women. But it’s abnormal. So get it evaluated. 
  2. Abortion / Ectopic pregnancy: Conception occurs in mid-cycle and so by the time a menses start, one could be a pregnant too. So excess bleeding occurring at menses could be also due to an abortion or miscarriage. Unlike the usual course of pregnancy, if the fertilised egg gets stuck in the fallopian tubes and develops there, It results in Ectopic pregnancy. Excess bleeding can be a sign of ectopic pregnancy too.
  3. Fibroids: Growth of fleshy solid tumours in the wall of uterus namely Fibroids can lead to excess bleeding. 
  4. Cancer: Cervical, ovarian and uterine cancers are rare causes of heavy bleeding, but it is possible. So early detection of these conditions is better for treatment. 
  5. Adenomyosis: This is common in middle-aged women who have given birth to more than two children. In this case, the glands that appear in the lining of the uterus become deeply embedded in the muscle of the uterus wall. These women with adenomyotic uterus have severe dysmenorrhea ( pain during menses ) and excess bleeding. 
  6. Intrauterine device: IUD used for birth causes more bleeding during menstruation. In some the bleeding reduces over time, but if in excess one must get evaluated. 
  7. Pelvic inflammatory disease: PID is an infection that occurs in the uterus, other reproductive organs and the fallopian tubes. Inflamed reproductive organs bleed more and hence cause menorrhagia. 
  8. Other diseases and disorders: Diseases like that of liver, kidneys and thyroids can cause excess bleeding. Disorders in blood levels or platelets can also be a cause. 

Treatment for excess bleeding 

Several treatments are available to treat heavy bleeding during menstruation. Choosing the right one mainly depends on the reasons that cause heavy bleeding.

Non-surgical treatments: 

  1. Hormonal therapy: This therapy is used as a treatment to stabilise the lining of the uterus (endometrium) and thus regulate the menstrual bleeding. 
  2. Non-hormonal medication: A tranexamic acid is a non-hormonal medication prescribed by the doctor that promotes clotting of the blood.
  3. Nonsteroidal drugs: Nonsteroidal medications that are anti-inflammatory like Ibuprofen, mefenamic acid helps to reduce blood loss. 

Surgical Treatments 

  1. Hysteroscopy: A long and thin scope can be inserted into the uterus through the cervix and the vagina. The doctor observes the lining of the uterus, remove the excess lining or the endometrial polyps that cause bleeding. 
  2. Dilation and curettage: In this procedure, the mouth of the uterus (cervix) to be dilated and the lining of the uterus is scraped off to make it shed all at once and stop bleeding. 
  3. Hysterectomy: This involves removing the uterus. It is mainly done for uterus having adenomyosis, fibroids, or cancers, or when the patient does not respond to medical therapies. 
  4. Ablation: Ablation or endometrial resection allows removal of the lining of the uterus. But it may be a temporary measure as the lining recurs. 

To conclude, proper diagnosis, choosing the right treatment for excess bleeding at menses needs to be done urgently as it affects the overall health of the women suffering from it.

Is Postmenopausal Bleeding Normal?

MBBS, Md - Obs & Gynae
Gynaecologist, Faridabad
Is Postmenopausal Bleeding Normal?

Most women attain menopause between the ages of late 40s and early 60s, the average age being about 51. This is an important milestone in a women-s gynecological history. One major change is altered female hormone levels, and this leads to a lot of physiological changes. From hot flashes to mood swings, there is also increased predisposition to osteoporosis and uterine cancer.

If you have not had your menstrual cycles for close to 12 months, chances are you are into menopause. So, that means absolutely no vaginal bleeding anymore whatsoever. However, if you experience bleeding, even spotting, be on the alert. It is not normal and needs to be examined, and if required, diagnosed and treated.

Postmenopausal bleeding or PMB as it is popularly called can be due to a variety of reasons. While it could be something as trivial as inflammation of the uterine or vaginal lining, it could also be an indication of more severe issues like cancer.

-  Atrophic vaginitis - Decreasing hormonal levels lead to increased dryness and therefore inflammation of the vaginal and uterine tissue. This is one of the common causes of bleeding after menopause.
-  Endometrial atrophy - Also caused by lower hormone levels, the lining of the body of the uterus gradually thins down and can get inflamed.
-  Polyps - Noncancerous growths in the uterus, cervix, vulva, or vagina can also lead to bleeding
-  Infections - General infection of any area along the uterine tract could lead to occasional bleeding
-  Cancers - Though only 1 in 10 PMB cases turn out to be cancers, the prognosis improves with early diagnosis and intervention.

Diagnosis

As repeated above, reach out to your doctor if you notice postmenopausal bleeding.  Diagnostic methods could include the following :

-        Physical exam
-        Transvaginal ultrasound
-        Endometrial biopsy
-        Hysteroscopy
-        Dilatation and Curettage

Treatment

Needless to say, this would depend on the diagnosis.

For very minor cases with diagnosis like altered hormone levels, no treatment may be required other than modification of the hormone replacement therapy.

For endometrial atrophy and atrophic vaginitis, use of estrogen creams and pessaries would be sufficient.

Polyps would require removal followed by cauterization (application of slight heat) to stop the bleeding.

Cancer - this would depend on the type and location and require a combination of chemotherapy and surgery.  Removal of the uterus also may be required in some cases.

So, if you have had bleeding of any sort after ayear of menopause, do not ignore it.  

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