Lybrate.com has an excellent community of Gynaecologists in India. You will find Gynaecologists with more than 35 years of experience on Lybrate.com. We will help you find the best Gynaecologists online in Delhi. View the profile of medical specialists and their reviews from other patients to make an informed decision.
Book Clinic Appointment with Dr. Puja Sharma
Treatment of Swelling
Treatment of Swelling of Legs
Caesarean Section Procedure
Well Woman Healthcheck
Treatment Of Menstrual Problems
Treatment of Pcod Problems
Submit a review for Dr. Puja SharmaYour feedback matters!
Patient Review Highlights
Most couples look forward towards completing their family with a child. However, getting pregnant isn’t easy for everyone. The inability to conceive a child despite having unprotected sexual intercourse for a year is termed as infertility. Infertility can be caused due to issues related to both man and woman's health.
Reasons behind infertility in women:
- Ovulation disorders: Many women suffer from hormonal disorders such as PCOD which prevents the formation of egg by the ovaries as per the monthly cycle. If the ovaries do not release eggs at the right time, sperm cells will have nothing to fertilize. Hyperthyroidism and hypothyroidism are two other common hormonal disorders that can affect ovulation. In addition to this, your ovulation cycle can get adversely affected by eating disorders, exercising too much or an injury.
- Fallopian tube damage or blockage: The ovaries are connected to the uterus through fallopian tubes. Once an egg is released by the ovaries it must pass through these tubes to reach the uterus where it can be fertilized. In some cases, a woman may have a damaged fallopian tube as a result of pelvic inflammatory disease, endometriosis or any other problem. In such cases, the inflammation and scarring can restrict the egg’s movement and keep it from being fertilized.
- Poor egg quality: It is important that the health of the egg must also be considered as a poor quality egg can cause complications at a later stage during the pregnancy. There are a number of factors that can affect the quality of an egg being released. Some of the most important factors are age of the woman, stress level and overall physical health.
Some of the most common causes of infertility in men are:
- Poor sperm quality: To penetrate the egg and fertilize it sperm cells must be the right shape and be agile. Thus sperm health includes the shape of sperm cells, sperm motility and tail whip. The quantity of sperm cells produced also plays a large role in determining a couple’s fertility. Low sperm count and poor quality sperm could be the result of prolonged exposure to electromagnetic frequencies, smoking, poor diet and alcohol consumption.
- Blocked Vas Deferens: The Vas Deferens is the tube through which sperm travel from the testicles to the penis. A blockage in this tube will restrict the amount of sperm being ejaculated and can cause infertility. This blockage may be caused by scarring as a result of an STD or varicocele.
PMS is often treated as a joke but for many women, it is a monthly nightmare. Muscle cramps, headaches, bloating, breast tenderness, anxiety and depression are common symptoms of PMS. Though there is no set cure for PMS here are a few tips that will help you deal with it.
- Set an exercise routine: Exercising not only helps you maintain weight but also helps to deal with PMS. You only need to set aside 30 minutes a day for a brisk walk, jog, swim or even dance. Aerobic exercises improve blood circulation, ease stress and help the brain release happy hormones.
- Change your diet: If you are feeling bloated and depressed, cut back on simple carbohydrates like sugar and fat and increase your consumption of complex carbohydrates like fruits, vegetables and whole grains. Do not attempt a low carb diet to lose weight if you suffer from PMS. Reducing the simple carbohydrates in the body and increasing the complex carbohydrates keeps your body feeling full for longer and increases the serotonin levels in the body.
- Quit alcohol and caffeine: Drinking a glass of wine or a cup of coffee may give you temporary relief from PMS symptoms but in the long run, they aggravate your PMS symptoms such as headaches, breast tenderness and mood swings. Alcohol may also contribute towards lowering the magnesium levels in your body and thereby make you feel bloated.
- Relax: One of the effects of PMS is to make you feel anxious and tense. The easiest way to address this is by learning to relax. Try meditation or yoga for half an hour every morning. This will improve your overall health as well as soothe muscle pains.
- Take a few supplements: Research says that certain fatty acids like Omega 3 and linoleic acid can lower irritability and body aches associated with PMS. Calcium is also known to help ease PMS symptoms. Getting these nutrients in the required levels may not be possible only through your daily meals. Hence, you can also consider supplements to ease your pains.
- Use Birth control pills: Birth control pills with the drospirenone hormone can help ease symptoms of severe PMS. Menstruation is often accompanied by a drop in estrogen levels that can lead to migraines. Birth control pills also regulate your hormones and hence, avoids these fluctuations. It also keeps your ovaries from releasing eggs every month and hence reduces the intensity of the associated cramps.
- Talk to people: You are not alone when it comes to PMS. Instead of keeping quiet about your discomfort, talk to people who may be experiencing something similar. Sharing your problems will introduce you to new ways of dealing with it. You could also get online support through various discussion groups.
Hypertension or high blood pressure is common in pregnant women, even in those who have no previous history of high blood pressure. This leads to complications in about 6 to 10% of all pregnancies around the world. High blood pressure may develop before or after conception and as such needs special medical attention.
Hypertension prevents sufficient flow of blood to the placenta and this inhibits the normal growth of the fetus. This could result in low birth weight of the child. However, if diagnosed in time and treated properly, hypertension does not affect the child's health too much.
- Gestational hypertension: This type of hypertension is developed about 20 weeks after conception. There is no abnormality in urine or any signs of other organ damage (as is common with hypertension during pregnancy) but the condition can worsen and complicate very quickly. Pregnant women below the age of 20 and above the age of 40 are often diagnosed with high levels of blood pressure. Women who have heart or kidney conditions before pregnancy and women carrying more than one child are also likely to develop gestational hypertension.
- Chronic hypertension: Chronic hypertension is high blood pressure which develops around 20 weeks before conception and does not normalize within 12 weeks after childbirth. The patient may also have been suffering from high blood pressure for a long time but the complications appear only during pregnancy because high blood pressure rarely exhibits symptoms without an associated condition.
- Chronic hypertension superimposed with Preeclampsia: Women who have hypertension before pregnancy may develop even higher blood pressure levels during pregnancy. This leads to several health disorders like frequent headaches, fatigue and depression.
- Preeclampsia: Preeclampsia is often a serious complication of gestational pregnancy and affects about 5% to 7% of all pregnancies globally. Gestational pregnancy does not always develop into preeclampsia but it needs to be diagnosed and treated in time to avoid the complication. Women who have conceived for the first time or have a history of hypertension in the family are at a greater risk of preeclampsia. The symptoms of the condition are throbbing headaches, blurred vision, nausea and vomiting, pain in the upper abdominal region and shortness of breath.
During pregnancy, it is not uncommon for women to contract thyroid diseases like gestational hyperthyroidism and gestational hypothyroidism. The main problem, however, is that the symptoms of gestational hypothyroidism are very much similar to those, which can be observed during normal pregnancy. The difficulty in differentiating between the two is the sole reason why many pregnant women are caught unawares, eventually resulting in further complications after the first trimester.
If gestational thyroid diseases are left untreated, you and your baby may experience a ton of problems such as preeclampsia, low birth weight, miscarriage and premature birth among others. Needless to say, if you already have a history of pre-existing hypothyroidism, then you will most certainly need more medical attention that is required.
Symptoms of gestational hypothyroidism, like high fatigue and excessive weight gain, are hardly distinguishable from those associated with a normal pregnancy. Other symptoms can also include:
- Severe constipation
- Muscle cramps
- Trouble sleeping
- Hair loss
- Dry skin
- Difficulty in concentration
- Memory problems
- Intolerance to cold temperatures
There may be a variety of causes that are responsible for the development of gestational hypothyroidism but the most common cause is usually an autoimmune disease known as Hashimoto's thyroiditis, which stimulates the body's immune system to attack thyroid gland cells, leading to a deficiency in the number of active thyroid cells and enzymes, and ultimately resulting in a shortage of the thyroid hormone.
Treatment for gestational hypothyroidism is normally uncomplicated, and follows just two simple steps:
- Proper diagnosis, via the use of a synthetic hormone called levothyroxine, which is very much similar to the hormone T4 produced by the thyroid.
- Continuous monitoring of thyroid function tests held every four to six weeks during pregnancy.
Menorrhagia is menstrual condition characterized by an abnormal loss of blood or heavy, prolonged bleeding. Although heavy bleeding is not uncommon in premenopausal women, menorrhagia is a severe condition which generally interferes with your daily activities. If your vagina bleeds irregularly or between periods, in addition to such heavy bleeding that at least one pad or tampon gets soaked every few hours, it is highly recommended that you seek medical attention.
Signs and symptoms of menorrhagia include:
- Soaking through more than one tampon or sanitary pad for every few hours
- The need to use double sanitary protection
- Heavy bleeding for weeks on end
- The need to wake up at night to change your sanitary protection
- Restriction of daily activities due to heavy menstrual flow
- Symptoms of fatigue, such as excessive tiredness as well as shortness of breath
Although the exact causes are unknown, here are a few causes that may be responsible:
- Hormonal imbalance is when there is an hormone imbalance, the endometrium develops in excess and sheds away with menstruation
- In Ovary dysfunction, if your ovaries do not ovulate, your body won't be able to produce the hormone progesterone resulting in a hormonal imbalance problem which may lead to menorrhagia
- Uterine fibroids are benign tumors which start appearing in your childbearing years
- Polyps are small benign growths found on the uterine lining
- Adenomyosis occurs when your glands from the endometrium becomes embedded in the uterine muscle
- By using Intrauterine device (IUD) menorrhagia may occur as a side-effect
- Pregnancy complications, for instance, an ectopic pregnancy can cause it
- Inherited bleeding disorders, such as von Willebrand disease
- Certain medications like anti-inflammatory drugs
- Other medical conditions, like pelvic inflammatory disease or endometriosis
Treatment for menorrhagia depends on a number of factors like the cause and severity of the condition, or your tolerance for specific therapies or medications.
Some drug therapies for menorrhagia include:
- Iron supplements
- Tranexamic acid
- Oral progesterone
- Non steroidal anti-inflammatory drugs
- Oral contraceptives
- Hormonal IUD
If drug therapy is ineffective, other treatment options may include:
'Congratulations! You're pregnant!' Almost all women long to hear these words and nothing should come in the way, even diabetes. So, if you are a Type 1 or Type 2 diabetic, here are a few things you should keep in mind to have a healthy baby.
- Your blood sugar must be monitored regularly: The most important thing you can do to have a healthy baby is to keep your blood sugar as close to normal before and during your pregnancy. Testing is recommended a minimum of four times a day. Glucose passes through the mother's blood to the fetus and hence if your blood sugar fluctuates, so will your baby's. High blood sugar levels are especially harmful during the first 8 weeks of pregnancy when the baby's brain, heart, kidneys and lungs are formed.
- Your pregnancy is considered high risk: High blood sugar levels can increase the risk of a miscarriage as well as the risks of your baby being born with birth defects. Diabetes can also increase the risk of developing preeclampsia during the second half of your pregnancy. This could result in a C-section or premature birth. Thus, maintain regular checkups and keep your doctor in the loop of all your activities.
- You should watch out for signs of ketosis: When you have low blood sugar, the body produces ketones that can be passed on from you to your baby. This production of ketones is a result of the body's burning of fat instead of glucose to provide energy and can develop a condition called ketosis. Symptoms you should watch out for are stomach aches, nausea, fatigue, muscle stiffness, frequent urination and fruity breath.
- You need Vitamins and Supplements: Most women require vitamin and mineral supplements at the time of pregnancy. Of these, folic acid, iron, calcium and vitamin D are the most important. These supplements help in the healthy growth of the baby.
- You should exercise regularly: Maintaining a regular physical activity routine is very important for diabetics who are expecting a baby. This will help you regularize your blood sugar, relieve stress and strengthen your heart. Avoid activities that increase your risk of falling and aim for at least thirty minutes of daily exercise such as walking, swimming or yoga.
- Check your medication: Some medication can be detrimental during pregnancy such as cholesterol and blood pressure medication. Consult your doctor to find a suitable alternative if needed. You may also need to change the kind of insulin you take and its frequency and amount. As you get closer to the delivery date, your insulin requirement may even double or triple.
The key to preventing complications during pregnancy is controlling your diabetes. So take your insulin regularly, maintain regular checkups and eat healthy. You need to be seen by your obstetrician more frequently. Your pregnancy will be monitored closely by more frequent ultrasounds and NST. If your sugar level remains under control and pregnancy is advancing well, a natural onset of pains is aimed for and normal delivery is expected.
Hi, I taken contrakit. I tablet of mifepristone. And next day one tablet of misoprostol. And after 1 hour I start bleeding from 2 pm to whole day. After that it stop. Is have to take another tablets Or what? Please tell me.
Menstrual disorders are caused by a variety of factors and affect every woman in a different manner. In most cases, it manifests itself in the form of fluctuations in menstrual flow and irregularity in the monthly cycle. Certain disorders are not too severe and can be easily alleviated. Others are more complicated and require the immediate attention of a gynaecologist.
As mentioned, there are different specific causes of different kinds of disorders resulting from a range of factors such as hormone levels, the functioning of the central nervous system, health of the uterus, etc.
- Hormonal imbalance: Fluctuating hormone levels in the body have a direct impact on the menstrual cycle. These fluctuations can be caused by dysfunction in the pituitary gland, thyroid gland or adrenal gland. It can also be a result of a malfunction in either or both ovaries and the secretion of hormones originating there.
- Anatomic problems: One-fourth menstrual disorders are caused by problems of the anatomy. These include various gynaecological issues like the presence of uterine fibroids and polyps, reduced uterine contractile strength, adenomyosis (intrusion of uterine tissue into the muscular wall of the uterus), a uterus with an excessively large surface area, and endometrial cancer.
- Clotting irregularities: Abnormality in clotting is a cause of heavy menstrual bleeding in women. It leads to exceeding blood loss from minor cuts and gashes and makes one easily prone to bruising. This may also include medical conditions such as thrombocytopenia (platelet dysfunction) and Von Willebrand disease.
- Medications and supplements: There is a wide range of medications and nutritional or hormonal supplements which often cause menstrual disorders in women and lead to fluctuations in the menstrual cycle. These include medicines such as aspirin, ibuprofen, estrogen pills, Vitamin E supplements etc.
- Miscellaneous factors: These are comparatively rare and require a greater degree of medical attention. It includes conditions such as cervical cancer, ovarian tumors, liver and kidney diseases, uterine infections, extreme psychological stress, obesity, etc. Incidents such as miscarriages and unsuspected pregnancies are also known to cause abnormal menstrual bleeding.
It's said that blocked fallopian tube is the most common cause of female infertility in about 40% women. Fallopian tubes are channels through which the egg travels to reach the uterus and blockage of these tubes can put a stop to this from taking place. Depending on the different parts of the tubes, this form of blockage is of several types.
What are the different types of fallopian tube blockages?
- Proximal tubal occlusion: This form of fallopian tube blockage involves the isthmus (an area of about 2 cm long, this part of the fallopian tube connects the infundibulum and ampulla to the uterus). This problem occurs due to complications associated with abortion, cesarean section or PID (pelvic inflammatory disease).
- Mid-segment tubal obstruction: It occurs in the ampullary section of the fallopian tube and is most frequently a result of tubal ligation damage. The procedure of tubal ligation is performed to put a stop to pregnancy permanently.
- Distal tubal occlusion: This is a kind of blockage wherein the section of the fallopian tube that is close to the ovary is affected and is commonly associated with a condition known as hydrosalpinx (a condition in which the fallopian tube is filled with fluid). The latter often happens due to Chlamydia infection, leading to fallopian tube and pelvic adhesions.
The conditions that may give rise to this problem can include:
- Genital tuberculosis (the TB infection that occurs in the genital tract)
- Ectopic pregnancy (pregnancy in which the embryo places itself outside the uterus)
- Tubal ligation removal
- Complications related to surgery of the lower abdomen
- Pelvic inflammatory disease (PID)
- Uterine fibroids (benign growths that occur in the uterus)
- Endometriosis (development of uterine tissue outside of the organ)
These disorders can lead to the development of scar tissue, adhesions, polyps or tumors to form inside the pathway. Additionally, the tubes can also get stuck to other body parts such as ovaries, bladder, uterus and bowels. Two things can happen to the fallopian tubes, either they can become twisted or the walls of the tube may stick together, leading to complete blockage.
Moreover, even if the fallopian tubes are partially damaged, they can remain open so as to enable pregnancy to occur, while increasing your risk for ectopic pregnancy.