Symptoms and preventions for Menopause
Hi Good morning! I am doctor Aparna Jain, senior consultant obstetrics and gynaecology. Today we are discussing problems related to menopause. Average age of menopause in an average Indian woman is 48 years. 2/3 years beyond that and before that is the period of perimenopause. Lot of women suffer from problems related to menopause first of which is hot flashes, another is urinary problem and sometimes menstrual disorder. Then there can be joint pains as well.
1. Hot Flashes. In hot flashes women usually feel lot of sweating and nervousness. Deficiency of hormones lead to hot flashes, for that we need to supplement the woman with hormones and usually we ask to avoid taking hot drinks and advice to take natural isoflavones to avoid hot flashes.
2. Menstrual Disorder. Menstrual disorder usually happens in the form of either irregular periods or heavy menses and irregular period usually occur in the initial six months to one year time then the period usually stops. If the period continues to be irregular then we need to do investigation to find out whether this woman is having any benign disorder in the uterus or malignant disorder in uterus. For that we need to do an ultrasound of lower abdomen and if required a D&C Hysteroscopy to find out whether there is any growth inside the uterus and we send this tissue for histopathology to rule out malignancy. If the bleeding till persists then the woman may need hysterectomy in that age.
3. Urinary Problem. It is quite common. Usually women do not come out with this problem because they feel shy about disclosing it. The most common problems are either frequency or dysuria which means burning during urination. Another is stress incontinence. Whenever they sneeze or cough they pass small amount of urine. It is all because of hormonal deficiency. Because of which the lining of the urinary bladder as well as the lining of the vagina becomes thin so there is chances of recurrent infection and women suffer from this problem. For this we need to supplement the women with hormones as well as ask them to take natural sources of oestrogens like soya isoflavones.
4. Joint Pain. Usually this is because of the deficiency of Vitamin D and Calcium. For this we need to address and tell them to do lot of exercises and to take Calcium as well as Vitamin D
Usually we subject every woman with health package during menopausal period in which we include a pap smear, and ultrasound routine, blood test like CBC, blood count, as well as lipid profile and kidney function test, sugar, urine routine culture, ultrasound of lower abdomen and if required mammography and if we find any problem one can go for a cardiac check up also. And, usually we tell every post menopausal woman to do some amount of exercise and take calcium and vitamin d and plenty of liquids to avoid any problem related to postmenopausal.
Thank you very much. If you have any problem related to this you can consult me either on Lybrate or you can come down to my clinic.read more
Benefits of Endoscopic Surgery
I’m Dr. Aparna Jain, Senior Consultant Obstetrics and Gynaecologist.
We are going to discuss about Endoscopic surgery or Laparoscopic surgery in gynaecology. It is basically a pinhole surgery in which doctors don’t open the abdomen. We just put two or three small scar at the abdomen, pet par do ya teen chote scar lagate hain jiske through we can do surgeries.
Various surgeries can be performed laparoscopically or endoscopically like removal of uterus, removal of fibroids from the uterus, removal of ovarian cyst, or ovary me jo gaanth hai uske removal ke lie kar sakte hain, or removal of cyst, any type of cyst like familial cyst or atopic pregnancy i.e, pregnancy inside the fallopian tube. It is outside the uterus and it a is very life threatening condition in which we can do laparoscopic surgery and take out the embryo.
Another issue which can be solved through laparoscopy is the case of infertility. Suppose Somebody, Who is not able to conceive. If there is some problem in the fallopian tube which can be opened by Laparoscope. Endometriosis is another very important problem which leads to infertility which can be corrected laparoscopically.
These are the various conditions which can be dealt with laparoscopy without opening the abdomen. What is the advantage? Why is laparoscopic surgery better rather than opening abdomen?
It is very very important to know about it because logo ke dimag me yeh myth hota hai ki abdomen open karenge toh complete surgery hogi aur laparoscopically agar surgery karenge to wo complete nahi hoga but it is not like that. If we are doing laparoscopic surgery we are having ten times magnification in comparison to a normal eye so it will give better vision, better insight to the disease which we will be able to handle better and the scope of recovery in laparoscopic surgery is much faster than open surgery.
There is not a single large scar on the abdomen. There are multiple, two, three or sometime four scar which is 1 cm or 0.5 cm scar at the abdomen which heal so well that post of pain is very very little after laparoscopic surgery. One is very early, one can ambulate very fast after laparoscopic surgery in comparison to open surgeries and post of addition formation. Sometime, after doing a surgery one landed up in another surgery then, after open surgery there is lot of addition formation inside so second surgery become very difficult but in laparoscopic surgery addition formation is very little so the second surgery becomes easier if somebody has laparoscopic surgery initially. Cosmetically, it is also very good because scars are very less, very little. It is almost an invisible scar in comparison to open surgery.
If you want to consult further, want to know more about laparoscopic surgery or you have any problem, for that you want to consult, you can consult us on Lybrate website.
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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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Premenstrual syndrome is a common condition that affects women who are menstruating. A multitude of psychological and physical symptoms might show up before the onset of a menstrual period. What causes PMS is unknown, but fluctuating hormonal levels (progesterone and oestrogen) seem to be linked to it.
PMS has many symptoms. These vary in severity and frequency and aren’t the same in every woman. These are the common symptoms of PMS:
1. Tenderness of breasts
3. Increase in weight
5. Impaired concentration
6. Backaches or headaches
10. Depression or mood swings
11. Overeating or food cravings
A doctor might recommend a few tests to understand and rule out related symptoms:
- Diary: Keeping track of the PMS symptoms in a diary for a few months to check the duration will help you understand the condition better. You might be able to see recurring patterns in your behaviour and moods after keeping track of them for few consecutive months.
- Thyroid test: Thyroid disease is fairly common in women and a lot of its symptoms match those of PMS. To rule out any thyroid problem, a test can be done to check the efficiency of the thyroid.
Relief can be found by treating the symptoms as there is no prevention of the condition. A nutritious diet, sufficient rest and exercise can help deal with the symptoms better.
- Nutrition: Proper nourishment leads to overall mental and physical well-being. Dietary changes like consuming less caffeine, sugar and salt might reduce the PMS symptoms. Supplements prescribed by your doctor such as vitamin E, calcium, magnesium and vitamin B6 help as well.
- Medications: Painkillers such as naproxen, ibuprofen and aspirin may provide relief from cramps, backache, breast tenderness and headache. If the PMS causes severe depression, your doctor may prescribe certain antidepressants.
- Being Informed: Tracking your periods by maintaining a monthly diary can help you understand and in turn prevent the severity of the PMS symptoms. Learning about coping mechanisms can help you as well.
In case you have a concern or query you can always consult an expert & get answers to your questions!
In medical terms, the pelvic floor refers to a group of muscles in the pelvic area. These muscles provide support to the organs in the pelvic region, including the bladder, uterus (women), prostate (men), and rectum.
What is pelvic floor dysfunction?
This is a medical condition that is used to refer to a situation when you are unable to control the functioning of the pelvic floor. It means you fail to control the bowel movement. People suffering from pelvic floor dysfunction use these muscles to contract rather than to relax. It is for this reason that they cannot have a bowel movement. They often have an incomplete one.
What causes pelvic floor dysfunction?
In most of the cases, the exact reason behind this dysfunction is unknown. It is often believed that this condition is caused due to traumatic injuries to the pelvic area. This can happen after an accident and due to complications aroused after vaginal childbirth.
What are the symptoms?
There are several symptoms that are linked to this medical condition. You must visit your doctor if you come across the following signs:
- The feel of having several bowel movements within a short period of time.
- If you feel that you cannot complete a bowel movement.
- When there is constipation pain linked with bowel movements.
- A frequent urge to urinate.
- Painful urination.
- Pain in lower back.
- Continuous pain in pelvic region, genitals, or rectum.
- Pain during intercourse in women
How is pelvic floor dysfunction diagnosed?
It may be diagnosed through a physical examination by the doctor. You will ask several questions to know the case history and find out the cause. You may also be asked to take pelvic muscle control test by placing surface electrodes on the perineum or sacrum. A small device called a perineometer is also used for the same.
What are the best ways for treating pelvic floor dysfunction?
It can be treated without surgery. There are several techniques. Some of these are as follows:
- Biofeedback: It is done with the help of a physical therapist.He uses special sensors to watch and monitor the muscles.
- Medication: A low-dose muscle relaxant is prescribed to treat the same.
- Relaxation techniques: Your therapist may ask you to take up techniques for relaxation such as warm baths, yoga, and exercises.
- Surgery: If your physician finds out that the dysfunction is caused by a rectal prolapse or rectocele, he or she will take up surgery.
Pelvic Floor Dysfunction results in Urinary Dysfunction. Urinary incontinence is the unintentional passing of urine. It's a common problem thought to affect millions of people. There are several types of urinary incontinence, including:
- Stress Incontinence – when urine leaks out at times when your bladder is under pressure; for example, when you cough or laugh
- Urge Incontinence – when urine leaks as you feel a sudden, intense urge to pass urine, or soon afterwards
- Overflow Incontinence (chronic urinary retention) – when you're unable to fully empty your bladder, which causes frequent leaking
- Total Incontinence – when your bladder can't store any urine at all, which causes you to pass urine constantly or have frequent leaking
It's also possible to have a mixture of both stress and urge urinary incontinence.
Pelvic Organ Prolapse
Pelvic organ prolapse is a condition in which structures such as the uterus, rectum, bladder, urethra, small bowel, or the vagina itself may begin to prolapse, or fall, out of their normal positions. Without medical treatment or surgery, these structures may eventually fall farther into the vagina or even through the vaginal opening if their supports weaken enough.
In case you have a concern or query you can always consult an expert & get answers to your questions!
The uterus is a muscular structure held in place inside your pelvis with the help of muscles, ligaments, and tissues. These muscles weaken in women due to pregnancy, childbirth or delivery complications and can lead to severe complications. One such complication is a uterine prolapse. Uterine prolapse occurs when the uterus sags or slips from its normal position into the vaginal canal.
The causes of uterine prolapse are varied and include:
- Delivering a large baby
- Difficulty in labor and delivery
- Reduction in estrogen levels post menopause
- Traumatic childbirth
- Loss or weakening of the pelvic muscle
- Conditions which lead to increased pressure in the abdominal area such as a chronic cough, straining, pelvic tumors or accumulation of fluid in the abdomen
- Loss of external support due to major surgery in pelvic area
Uterine prolapse can be complete or incomplete depending on how far the uterus sags into the vagina. Women who have minor uterine prolapse may not have any visible symptoms. However, if the condition worsens, it manifests itself in visible signs.
Symptoms of moderate or severe prolapse are:
- A feeling of fullness or pressure in your pelvis when you sit
- Seeing the uterus or cervix coming out of the vagina
- Vaginal bleeding or increased discharge
- Painful sexual intercourse
- Recurrent bladder infections
- Continuing back pain with difficulty in walking, urinating and moving your bowels
Without proper attention, the condition can cause impairments in the bowel, and can also affect bladder and sexual function.
In case you have a concern or query you can always consult an expert & get answers to your questions!
Painful intercourse can occur for a number of reasons – ranging from structural problems to psychological concerns. Women experience painful intercourse atleast once in their entire lifetime. The medical term for painful intercourse is dyspareunia. It is a persistent or recurrent genital pain that occurs just before, during or after intercourse. Physical causes of painful intercourse differ, depending on whether the pain occurs at entry or with deep thrusting. Also, certain emotional factors can also be probable causes of painful sex.
Entry pain: Pain during penetration may be associated with a range of factors:
1. Insufficient lubrication
Insufficient lubrication is caused by a drop in estrogen levels after menopause, after child birth or during breast feeding. Certain medications inhibit desire or arousal, decreasing lubrication and making sex painful. These include antidepressants, high blood pressure medications, sedatives and certain birth control pills.
2. Injury, trauma or irritation
This can be injury from an accident, pelvic surgery, female circumcision or cut made during childbirth.
3. Infection or skin disorder
Infection in the genital area or urinary tract can cause painful intercourse. Eczema or other skin problems in the genital area can also cause problem.
1. Certain illness and condition
These include endometriosis, pelvic inflammatory disease, uterine prolapse, retroverted uterus, cystitis, hemorrhoids and ovarian cysts.
2. Surgeries or medical treatment
Scarring from pelvic surgery can sometimes cause painful intercourse. Medical treatments for cancer, like radiation and chemotherapy can cause changes that make sex painful.
1. Psychological problems
Anxiety, depression, concerns about physical appearance, fear of intimacy can contribute to a low level of arousal, resulting in discomfort or pain during sexual activity.
2. Stress and tension
You may have a million things to worry about in a day, but taking that tension to bed with you can lead to painful sex. Your pelvic floor muscle tightens in response to stress in your life. This can contribute to pain during intercourse.
3. History of sexual abuse
If you've had a history of some form of sexual abuse or are scared of sex, pain during intercourse because of your past experience(s) may be a possible cause for an unpleasant sexual experience in the present. Consult an expert & get answers to your questions!
Urinary incontinence is the term used to describe bladder control problems that affect several people. Many think it only occurs among older, menopausal women but it actually isn't uncommon amid young and active women.
Inability to control the bladder accompanied by pain can be symptomatic of various disorders ranging from a minor infection to cancer. Fortunately, bladder cancer is rare, and bladder pain is usually not serious.
The varied causes of urinary incontinence in women are as follows:
- Urinary tract infection: this is the most common cause of urinary incontinence and it affects women more than men due to anatomical factors. It can also happen at any age.
- Medicinal side effect: the inability to control one's bladder may be a result of the administration of certain medicinal substances such as alpha-blockers, antidepressants, sleeping pills and various narcotics.
- Changes in the reproductive system: pregnancy and fluctuations in hormone levels can cause bladder irritation, which leads to urinary incontinence.
- Impacted stool: when stool gets tightly packed in the lower end of the digestive system and rectum, bladder control is affected. Chronic constipation and constraint strain on the lower intestines leads to the weakening of bladder muscles and hampers the bladder control.
- Surgical side effects: temporary loss of control of the bladder is often a result of prior surgery and radiation therapy in the pelvic region.
- Nerve damage and neurological disorders: strokes and spinal cord injuries have a heavy impact on bladder control and amount to urinary incontinence. Diseases such as Alzheimer's disease, Parkinson's disease and multiple sclerosis also lead to the same.
- Health complications: disorders such as diabetes and obesity directly affect the bladder and the ability to exercise control over it.
- Disability and impaired mobility: for women who are physically impaired and suffer from problems of arthritis, urinary incontinence is a major problem as they are unable to reach the toilet easily.
- Bladder cancer: even though it is extremely rare, bladder cancer affects a number of women every year and is treated through surgery and chemotherapy. If you wish to discuss about any specific problem, you can consult a Gynaecologist.
There are technical ways in which you can get your body all set for labour. Although you may not know how your labour will progress, you can ease the pain that you experience during childbirth to a significant extent by doing these four exercises:
1. Kegel Exercises: These exercises target the muscles that provide support to your bladder, uterus, urethra and rectum. By strengthening the muscles of the pelvic floor, these exercises help in improving the flow of blood to your vaginal and rectal area. Kegel exercises involve contracting of the muscles of your pelvic floor as you would do if you had to prevent passing urine or stool. It is also known to reduce the duration of the pushing stage of childbirth, which is the second stage. You can do the exercises sitting or standing and in either of the two ways-
Slow kegel: For this, contract the muscles of your pelvic floor and hold them for 3-10 seconds. Release and repeat the exercise for ten times.
Fast kegel: To do this, you need to contract and loosen up your pelvic muscles 25-50 times. Do the set for about 4 times with 5 seconds interval between each set.
2. Squatting: Practising squatting during your pregnancy can help in preparing your pelvic muscles for labour. While strengthening your thighs, it opens up your pelvis for an easy descent of the baby. So, here’s what you should do:
1. Begin by standing behind a chair for support with your feet wide apart
2. While contracting your abdominal muscles, relax your shoulders and chest before lowering your tailbone towards the floor
3. While inhaling and exhaling deeply, push into your legs and go back into a standing position
3. Pelvic Tilt: This exercise helps in strengthening the muscles of your back, pelvis and thigh regions while improving posture. Ensuring your pelvic joints remain flexible, it eases the pain experienced during delivery. Here’s how it’s done:
1. Get down on both your hands and knees while keeping your head in a parallel position with your back
2. While arching your back, pull in your stomach
3. Hold this position for a few seconds before releasing
The exercise needs to be repeated 3-5 times - all the while maintaining a strong hold over your back and stomach.
4. Tailor Pose: The tailor pose is designed to help relax your hip joints as well as open up the pelvis. It also helps in improving your body posture while easing the aches that occur in the lower part of your back. For this, you need to perform the following steps:
1. While keeping your back straight, sit comfortably on the floor
2. Placing the soles of both the feet together, press your knees gently towards the floor
3. Keep the position for 10-15 seconds. You can repeat the exercise for 5-10 times. If you wish to discuss about any specific problem, you can consult a Gynaecologist.
Pelvic inflammatory disease (PID) refers to the infection that occurs in the female reproductive organs. It happens when sexually transmitted bacteria infect the uterus, ovaries or fallopian tubes on spreading from the vagina. Generally, the cervix plays the role of preventing the bacteria from entering the vagina and infecting the reproductive organs. But when the cervix becomes exposed to an STD, it loses its power to put a stop to the spread of these microorganisms to the reproductive organs.
What causes this condition?
STDs like gonorrhea and chlamydia have been found to be responsible for about 90% of PID cases.
Some of the other causes include
- Pelvic procedures
The condition is only detected later in life when you face difficulty in getting pregnant or have chronic pelvic pain complaints. If you experience symptoms like vomiting, high fever, pain in the lower abdomen and instances of fainting, you should immediately seek a doctor.
What puts you at risk for PID?
Certain factors may put you at a higher risk for PID and these are:
- Instances of sexually transmitted diseases like Chlamydia (an STD that can occur from anal, oral or vaginal sex) and gonorrhea (a condition that causes discharge from the vagina or urethra) can make you prone to developing PID.
- Douching on a regular basis can increase your risk of PID as it disrupts the equilibrium of good and bad bacteria in your vagina, and may hide the symptoms of the condition as well.
- Even a previous history of PID can increase your chances of having another episode of PID.
- Compared to older women, teenagers who are sexually active are more prone to developing PID.
- Having multiple sexual partners can also put you at a greater risk for PID and STDs. If you wish to discuss about any specific problem, you can consult a Gynaecologist.
Smoking during pregnancy can adversely affect not only your health but that of your unborn too. Kicking this habit can help you to have a safer pregnancy as well as a healthier baby. If not, it can lead to a number of serious pregnancy complications including the death of your baby. According to various findings, smoking during this period can double your prospects of having a baby with low birth weight as well as your chance for stillbirth.
What happens when you smoke while pregnant?
The cigarette smoke is made up of about 4000 chemicals, which includes about 60 cancer causing substances, lead, and cyanide. Of these toxins in cigarette smoke, carbon monoxide and nicotine are the two toxins that make up much of smoking-related pregnancy complication. The toxins go directly to your baby through the bloodstream, the only source of nutrients and oxygen for your offspring. By working in tandem, the nicotine and carbon monoxide toxins bring about a decrease in the supply of oxygen for your baby. While nicotine cuts off oxygen supply by constricting the blood vessels, the red blood cells responsible for carrying oxygen also pick up carbon monoxide molecules and take them directly to your baby.
What effects does it have on your little one?
When you smoke, you put your baby on harm's way and here's what happens to your baby:
- In terms of weight, it has been revealed that while smoking one pack daily can bring about a 226 gm decrease in the baby's weight, smoking two packs every day can affect your baby's weight by about 453 gm. A stunted growth during this period can negatively affect your child later in life.
- Due to the negative effects of the toxins, the development of your baby's lung and body gets hampered. It may also make your baby prone to Sudden Infant Death Syndrome (SID) and asthma.
- It can also increase your baby's chance of suffering from a heart defect. Research shows that babies whose mothers smoke during the first three months of pregnancy have 20-70% chance of developing congenital heart problems compared to babies whose mothers didn't smoke.
- Smoking can affect the development of his brain functions and cause him or her to suffer from low IQ, learning disabilities as well as behavioral issues. If you wish to discuss about any specific problem, you can consult a Gynaecologist.
Gynecological cancer is any tumor that begins in a woman’s reproductive organs. Cancer is usually named after the part of the body where it begins. Gynecologic cancer starts in different areas within a woman’s pelvis, which is the territory beneath the stomach and in the middle of the hipbones. There are different types of gynecological cancers and these are as follows:
- Cervical cancer starts in the cervix, which is the lower, narrower end of the uterus. The uterus is also called the womb.
- Ovarian cancer starts in the ovaries, which are situated on each side of the uterus.
- Uterine cancer starts in the uterus, the pear-shaped organ in a woman's pelvis where the child develops when a lady is pregnant.
- Vaginal cancer starts in the vagina, which is the empty, tube-like channel between the base of the uterus and ends as the vaginal opening.
- Vulvar cancer starts in the vulva, the external part of the female genital organs.
Signs and symptoms of the above-mentioned gynecologic cancers can be very vague; however, there are a few issues each lady needs to know about and look for. The following are some of the common symptoms of different gynecological cancer:
- Swollen leg (ordinarily happens in one leg and comes with pain or discharge)
- Irregular vaginal bleeding (particularly in a lady who has experienced menopause)
- Unexplained weight loss
- Consistent bladder weight or increased urination
- Loss of appetite, while always feeling full
- Pelvic or stomach pain
- Bloated stomach
- Consistent weakness
- Compelling, sudden onset bloating
- Trouble eating or feeling full rapidly
- Urinary indications (urge or recurrence)
- Vaginal draining or spotting after menopause
- New onset of heavy flow during periods or bleeding between two-period cycles
- A watery pink or white discharge from the vagina
- Two or more weeks of steady pain in the lower abdomen or pelvic region
- Pain during sex
- A red, pink or white bump that has a crude or wart-like surface
- A white area that feels unpleasant and rough
- Continuous itching
- Pain or a smoldering feeling while urinating
- Bleeding and discharge not connected with monthly cycle
- An open sore or ulcer that lasts over a month
A large portion of the symptoms connected with gynecologic cancers may occur due to other reasons every once in a while, which may make us ignore them. It is vital to be tuned into your body and pay consideration on any progressions. In case you see new side effects that are happening every day for more than a couple of weeks, this can be an indication of gynecological cancer. Try not to worry. Make sure to go for regular check-ups at your gynecologist. If you feel that the aforementioned symptoms are persistent, seek medical attention.