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Providing you personalized, ethical and quality health care...more
Providing you personalized, ethical and quality health care

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MON-SAT
05:00 PM - 08:00 PM

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8 Housing Board Colony, Main Jharsa Road, Patel Nagar, Sector 15
Sector-15 Gurgaon, Haryana - 122001
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Good morning, I m Dr Nidhi Agarwal, I am a consultant gynaecologist, based in Gurgaon. Now today ...

Good morning, I’m Dr Nidhi Agarwal, I am a consultant gynaecologist, based in Gurgaon. Now today I’ll speak on Polycystic Ovarian Disease that is PCOD which is very common in women in recent years.

PCOD actually occurs in young women. They usually present to us with irregularity with their periods. The ovaries in PCOD patients actually become bigger and denser. As the name suggests, ‘poly’ means many that is many cysts are formed in the ovaries. This lady usually presents with a disruption in the normal menstrual cycle.

Now, what happens in a normal lady who menstruates every month?

There is one egg which is selected by nature which increases in size, and when it becomes bigger and appropriate in size, it is ruptured in the ovary which is then taken up by the Fallopian tube. And if it doesn’t meet the sperm and pregnancy doesn’t occur, then the lady menstruates. This should happen monthly up to 35 days. In PCOD patients, this natural selection of the egg every month doesn’t occur. Instead, many small cysts are formed in the ovaries. So that is why there are many cysts formed in the ovaries, and then the patient does not have normal periods. That is why we say it a Polycystic Ovarian Disease.

Now how does a patient of PCOD present to us?

A patient of PCOD, if she is a young girl in her teens or in the early twenties, she usually comes to us saying that she is not having her monthly periods. She menstruates at one and a half months, two months, two and a half months, and when she menstruates, she usually has excessive bleeding with clots. If a lady is in her late twenties and has got married, and she is not able to conceive, then also the patient presents with the problem in conceiving. Also, there is usually an excess of hormones produced by the ovaries, that is an excess of estrogen as well as androgen which is the male hormones. The lady usually presents with male like pattern of hair growth that is hair growth on her chin on her face, around the nipples of her breasts, in her lower abdomen, especially over her thighs and she says that along with excessive hair growth, she has developed excessive acne and things also appear all over her scalp. These are basically because of an excess of androgens, which are the male hormones. This change in the hormonal value occurs because of Polycystic Ovarian Disease. Also, very often, patients come to us saying that she is gaining weight excessively. A patient comes and says that in the last 5 months, I have gained 10 kgs of weight. So patients usually present to us with symptoms of insulin resistance, in which there is overweight. Now, PCOD has actually become very common and patients who are as small as 11-12 years of age come to me, young girls presenting with PCOD. And the incidence is very very very high; 1 out of 10 women are now having PCOD.

How do tackle this PCOD?

See, there are three criteria which are very important. As I have told you, first is a presentation, that the lady is not ovulating, that is the egg which is formed every month is not released. Instead, multiple eggs multiple cysts form which we call in their ovaries. So, if the ultrasound shows that they are polycystic ovaries if the patient presents to us with less ovulation, or anovulation which we say which occurs when the patient is not having her regular periods, or there are signs of excess androgen that is male hormone with features of hirsutism. Then, out of these three, if two criteria are there in the lady someone is having PCOD.

Very often patients ask me, ‘Why do we, why am I suffering from PCOD?’ So if you ask me, there is no one particular cause which I can see, that this is the reason you have got. There are so many factors, it could be just genetic- your mother or sister has been suffering from PCOD, then your chances of having PCOD are always higher. There could just be low-grade information in her ovaries, which has disturbed the ovaries to an extent that it is releasing more of male hormones, making them bigger in size and that is causing the ovaries not to ovulate. Or it could just be because of obesity and high insulin levels. Again, because of high insulin in the body, it puts stress on the ovaries and they don’t ovulate.

So there are so many causes, you have to investigate the patient, there are a lot of investigations that have to be done and we can come to a diagnosis, it is possible. So, I’ll just conclude by saying that PCOD is very very common nowadays.

If you are having problems with your menstrual cycle, if you are gaining weight abnormally, if you have excessive hair growth anywhere which is not expected in females, face acne or hair loss, please do see us, see your local gynecologist, so if there is any problem, it can be sorted out in time. I’m Dr Nidhi as I already told you, I am based in Gurgaon, and you can contact me for any queries for PCOD or its treatment at LivWell clinic which is at Galleria Market and also you can contact me through Lybrate.

Thank you.
 

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Doctors in Kidney and Prostate Clinic & Women's Clinics

Dr. Rajiv Goel

MBBS, MS - Surgery, M.Ch - Urology
Urologist
91%  (14 ratings)
20 Years experience
700 at clinic
₹500 online
Unavailable today

Dr. Nidhi Agarwal

MBBS, MD - Obstetrtics & Gynaecology
Gynaecologist
89%  (218 ratings)
17 Years experience
500 at clinic
₹300 online
Unavailable today
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Specialities

Urology

Urology

Offers cumulative treatment of problems of the Urinary tract and male reproductive organs
Gynaecology

Gynaecology

A branch of medicine reserved especially for treating female conditions of the reproductive system
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Services

Urinary Tract Infection (UTI) Treatment

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Minimally Invasive Urology

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Neurourology

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Reconstructive Urology

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Male Sexual Problems Treatment

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Sexually Transmitted Disease (STD) Treatment

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Female Sexual Problems Treatment

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Prostate Laser Surgery

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Open Prostatectomy

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Transurethral Incision of The Prostate (TUIP)

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Transurethral Resection of The Prostate (TURP)

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Urinary Tract Obstruction Treatment

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Castration Surgery

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Laparoscopic Urology

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Male Infertility Treatment

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Sexual Dysfunction Treatment

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Renal ( Kidney ) Stones Treatment

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Urinary Incontinence Treatment/Surgery

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Varicocele Surgery

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Circumcision Procedure

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Hydrocele Treatment (Surgical)

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Blood in Urine (Hematuria) Treatment

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Urinary Tract / Bladder Stones Treatment

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Vasectomy Procedure

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Male hypogonadism Treatment

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Lithotripsy

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Erectile Dysfunction Treatment

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Men's Health Problems

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Ureteroscopy

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Cystoscopy

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Nephrectomy (kidney removal)

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Pre-Marital Counselling

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Infertility Evaluation Treatment

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Pre-Pregnancy Counselling

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Assessment & Handling of High Risk Pregnancy cases(includes Deliveries)

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Management of Menopause

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Management of Heavy / Irregular periods

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Evaluation of Abnormal Pap Smears

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Evaluation and Management of pelvic pain

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Management of Ectopic pregnancy

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Management of Adenomyosis / Endometriosis

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Treatment of Fibroid Uterus

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Treatment of uterine / endometrial / fibroid polyps

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Evaluation and management of Ovarian cysts / tumors

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Gynecological Endocrinological Disorders

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Management of Adolescent Gynecological conditions

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Vaginal Infection Treatment

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Treatment of Urinary Infections

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Network Hospital

LivWell Clinic

209, 2nd Floor, Galleria Towers, DLF Phase - 4Gurgaon Get Directions
  4.5  (224 ratings)
2 Doctors
2 Specialities
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Patient Review Highlights

"Professional" 7 reviews "Prompt" 2 reviews "Well-reasoned" 6 reviews "Helped me impr..." 2 reviews "Thorough" 1 review "Practical" 3 reviews "knowledgeable" 26 reviews "Sensible" 5 reviews "Caring" 5 reviews "Very helpful" 54 reviews "Saved my life" 1 review "Inspiring" 1 review

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Reproductive Medicines - What You Need To Know About Them

Urologist
Urologist, Gurgaon
Reproductive Medicines - What You Need To Know About Them

Reproductive medicine has gained a lot of attention recently with its increasing scope and opportunity. This branch of medicine is concerned with improving reproductive health, preventing reproductive disorders, diagnosis of infertility issues and allowing couples to have children when they choose to be parents. The scope of reproductive medicine is based on endocrinology, anatomy and physiology. Here are some things you need to know about reproductive medicine:

Scope

Reproductive medicine includes many aspects of human health and other factors. Sexual dysfunction, puberty, birth control, sex education, family planning are some of the factors that it is concerned with it. In women, issues such as ovulation, menstruation, menopause and pregnancy are of immense importance in reproductive medicine.

Methods and techniques

Methods to assess any reproductive abnormality include reproductive surgery, laboratory methods while methods of treatment are prescription of fertility medication, counseling and surgery. In vitro fertilization or ivf has become one of the most effective treatments to enable pregnancy. This treatment allows the examination of the embryo before implementation.

Training

Specialists in reproductive medicine are trained in gynecology and obstetrics which is followed by infertility and reproductive endocrinology. Some of them specialize in urology followed by andrology. Training is also provided for contraception specialization. Usually, specialists in this branch of medicine receive education in particular organizations that deal with only human reproductive disorders.

1 person found this helpful

Urinary Incontinence in Old Age - 4 Ways To Help You Manage It!

Urologist
Urologist, Gurgaon
Urinary Incontinence in Old Age - 4 Ways To Help You Manage It!

Are you experiencing loss of bladder control? This might indicate that you are suffering from a health condition known as urinary incontinence. This involuntary leakage of urine is common in old age and may occur due to health hazards, such as Parkinson’s disease, an enlarged prostate, diabetes, and also due to prostate surgery. This is an embarrassing and irritating condition.

For aged people suffering from urinary incontinence, there are several ways of treatment. Here are the top treatment methods:

  1. Several food items such as caffeine, carbonated drinks and soda lead to bladder irritation and worsen the urinary incontinence symptoms. Alcohol being a diuretic is harmful too as it increases the urine amount. You must avoid coffee, carbonated drinks and alcohol for improving the urinary incontinence symptoms. You also need to make several dietary adjustments for treating urinary incontinence. Avoid spicy, acidic food which aggravates this condition.
  2. Stress is something which worsens the symptoms of urinary incontinence. In order to recover, you must try and eliminate all forms of stress. Attempt relaxation techniques like breathing exercises and meditation. Biofeedback is also essential for the observation of your bladder muscle contractions via a monitor. A behavioural technique called bladder training is also considered effective. Here, you have to urinate every hour, even though you do not feel the urge to. Try to increase the time between your bathroom breaks and slowly you will gain control over your urination urge.
  3. Flexing your muscles for gaining control over urinary incontinence is also very important. You can undertake Kegel exercises for boosting your pelvic muscle strength. You need to identify the specific muscles which will help you to stop the passing of gas. You can also try pads and undergarments which are disposable. These will prevent leaks, and skin irritation and odour problems.
  4. Certain medicines are used for treating urinary incontinence in older people. Many of the medicines help in relaxing the muscles so that unwanted bladder contraction is prevented. Other medicines block nerve signals to your bladder. In some cases, drugs are used to shrink an enlarged prostate. The ultimate option of urinary incontinence treatment in old age is surgery. A male sling is a common option in which a certain material gets wrapped around your urethra in order to compress it. Artificial sphincter is used as well for urinary incontinence treatment, where a cuff is used for closing the urethra and the urine is released when the pump is squeezed for opening the cuff.

If you experience any symptom of urinary incontinence, it is important for you to visit a doctor as soon as possible. This will enable you to have early diagnosis and treatment.
 

2 people found this helpful

Bladder Cancer - Risk Factors Associated With it!

Urologist
Urologist, Gurgaon
Bladder Cancer - Risk Factors Associated With it!

There are many types of cancer that may affect the human body. Bladder cancer is one such cancer that is caused when there is an abnormal growth and accumulation of the cells in the bladder. This kind of growth may cause mutations which can then manifest into tumours that may or may not be malignant.

Let us find out more about the causes and risk factors of bladder cancer.

  1. Transitional cell carcinoma: In this kind of bladder cancer, the transitional cells that line the inner region of the uterus and urethra will expand when the bladder is full. Further, these cells will end up contracting when the bladder is empty. This will lead to numerous complications which can cause the formation of tumours as an end result.
  2. Squamous cell carcinoma: The squamous cells are those that are usually found in the bladder as a response to any kind of infection or even irritation in the area. These cells become cancerous over a certain period of time. This is also one of the most common types of bladder cancer in the US, as per various medical reports.
  3. Adenocarcinoma: This kind of cancer usually starts in the cells that make mucus and form glands for the production of the same, in the bladder. This is a rather rare form of bladder cancer.
  4. Risk factors: There are a number of risk factors that may affect the manifestation of the abnormal cell growth which can lead to any one of the above types of bladder cancer. Let us learn more about these risk factors.
  5. Smoking: Smoking does not merely cause lung cancer, but it is also capable of causing chemicals from tobacco to accumulate in your urine and lead to several complications, including the increase of abnormal cell growth in the bladder. These chemicals may also cause widespread damage to the lining of your bladder.
  6. Diabetes medication: One of the side effects of taking certain types of diabetes medication may be seen in the bladder and its cells. Pioglitazone is one such medicine which can cause these kinds of complications.
  7. Chronic bladder inflammation: Repeated bladder infections may cause an unhealthy amount of persistent inflammation, which can lead to the growth of cells in an abnormal manner. This can lead to damage of the bladder’s inner lining. In such a case, bladder cancer becomes a risk for the patient.
  8. Family history: A family history of the condition also leaves the person susceptible to this disease. Colorectal cancer instances or Lynch syndrome cases in the family can increase the risk of contracting bladder cancer. This is due to the fact that the faulty gene can affect the various organs of the urinary area.
2 people found this helpful

Prostate Biopsies - Ways You Can Avoid It!

Urologist
Urologist, Gurgaon
Prostate Biopsies - Ways You Can Avoid It!

One of the most common issues with old age in men is the enlarged prostate. Any difficulty with urination (no constant stream, difficulty initiating, or incomplete emptying of the bladder for instance), and the first suspect is an enlarged prostate. These symptoms are followed by a digital rectal exam to check for an enlarged prostate. Once confirmed, the next step is to check for levels of prostate-specific antigen (PSA). If both the exam and the PSA are positive, it could mean prostate cancer. As with any cancer, it is believed that sooner it is diagnosed and the treatment is started, the better.

Historically, the best way to rule out the prostate cancer had been to do a prostate biopsy. This is a minor invasive procedure, wherein biopsies are taken from various regions of the prostate which are known to develop cancer (about 12). A disadvantage of this procedure includes missing out on the front part of the prostate which can also develop cancer. Secondly, it is not a very pleasant experience and given a chance, most men would not want to have it done.

There is good news for these men who would like to avoid prostate biopsies. The first is the multiparametric MRI which uses no x-rays and is considered very safe with extremely accurate results. This MRI exam requires about an hour, and once the images are obtained, the doctor will analyse these images and check for several parameters to assess for prostate cancer. The absence of cancer can be confirmed with up to 90% accuracy, which is far greater than with usual biopsies. If there is a possibility of cancer, then a biopsy can be done to confirm it.

Also, these images indicate the exact region where cancer likely is, and this guides the doctor to biopsy only where absolutely essential. The chances of false positive and false negative results are reduced drastically. The one disadvantage here is that MRI detected biopsies usually tend to be of a higher grade which requires immediate treatment.

Another way to reduce chances of the biopsy by 30% to 50% is by the 4K test. It helps detect a variety of prostate issues including cancer. It can be used once higher levels of PSA is identified and before going for a biopsy. It combined 4 prostate-specific biomarkers with clinical information to accurately provide men with a risk of developing prostate cancer. It can be used even after negative biopsies to confirm the diagnosis of prostate cancer.

These two measures can drastically reduce the incidence of prostate biopsies, which is neither pleasant for the patient nor very effective for the doctor.

In case you have a concern or query you can always consult an expert & get answers to your questions!

3400 people found this helpful

Hi I am going to get married in next 5 days would like to understand about the safe precaution measure I and my husband can undertake to avoid early pregnancy.

MBBS, MD - Obstetrtics & Gynaecology
Gynaecologist, Gurgaon
Hi
I am going to get married in next 5 days would like to understand about the safe precaution measure I and my husba...
Use barrier method i.e. Condoms now to avoid pregnancy. But the best contraceptive for a newly -wed is using oral contraceptive pills. So, go to a gynaecologist who will get a few tests done before prescribing you oral pills which are to be started from first or second day of your periods. Till that, use condoms.
1 person found this helpful
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Stress Incontinence Post Pregnancy - How to Treat It?

Urologist
Urologist, Gurgaon
Stress Incontinence Post Pregnancy - How to Treat It?

Many women experience stress incontinence during some time of their pregnancy or post pregnancy. The experience of incontinence varies from woman to woman and it is caused due to stretching of muscles and tissues that support the uterus, bladder and womb. It is also caused due to the weight of the growing baby in the womb as well as due to hormones. The tissues and muscles mainly represent the pelvic floor and on the birth of a baby, these pelvic floor muscles get stretched even more.

What you should know?

  • Stress incontinence is not a problem post pregnancy and especially once the child is born. However, some women continue to have issues at times due to weakening of pelvic floor muscles.
  • It is the weakening of the muscles that causes incontinence of a bladder which is overactive. Incontinence can also occur, if the fine nerves that surround the bladder are damaged at the time of delivery.
  • Women having problems controlling their bladder are more likely to have stress incontinence during pregnancy.

Simple treatment options to treat stress incontinence

  • There are some simple treatment options that can be followed to control urinary incontinence during pregnancy. The simplest option is definitely managing the fluid intake as well as scheduling visits to bathroom at regular intervals. In this way by setting a proper schedule, stress incontinence can be treated.
  • There are medical devices also available that help to strengthen the pelvic floor muscles and that can be used, if incontinence is persistent. The medical device can be used to block the urethra. The other simple option that can be effectively used to control incontinence post pregnancy includes toning the affected tissues and muscles. The urethra can function in an improved manner and any incontinence can be minimized after child birth by performing the Kegel exercises regularly, which provide great benefit.

Imperative tips
The foremost symptom of stress incontinence includes urine leakage and that happens at times when a woman is physically active, coughing, sneezing or while having intercourse. It is very important that a woman urinates when she feels the urge and does not hold it. In this way, the leakage of urine will be reduced. It is also essential that they avoid running around or jumping. It is advisable to quit smoking as it can reduce irritation of the bladder. Spicy food items, citrus fruits and carbonated drinks must be avoided as they can cause irritation to the bladder.

In case you have a concern or query you can always consult an expert & get answers to your questions!

3388 people found this helpful

Blood In Urine - Is It Actually Serious?

Urologist
Urologist, Gurgaon
Blood In Urine - Is It Actually Serious?

Most people would panic on seeing slightly red urine being passed. A common urologic condition, this happens because blood cells are leaking into the urine. There are multiple reasons which can cause it, and not all of them are major causes for concern.

Read on to know more about some common causes, and how to manage this.

  1. Urinary tract infections: There could be an infection of the entire urinary tract including the kidneys, the ureters, the bladder, and the urethra. In addition to blood in the urine, there could also be an urge to urinate, pain with urination, fever, and flank pain.
  2. Enlarged or infected prostate: The prostate naturally enlarges with age and can obstruct the urethra, causing pain and blood in the urine. There is a constant urge to urinate and difficulty initiating the stream. Infection of the prostate also produces similar symptoms along with fever and pain.
  3. Kidney diseases: In addition to infections, other kidney diseases including glomerulonephritis, which can also lead to hematuria. Kidney stones, which are quite common, are also another reason, and this will be characterised by the sudden sharp pain around the flank which is very diagnostic of kidney stones. Injury to the kidneys from trauma or sports is another reason for hematuria.
  4. Cancers/tumours: Cancers in the kidney, bladder, or prostate can cause blood to appear in the urine, but this would happen once cancer has reached some advanced stage, not very early in the process.

Listed below are some risk factors for hematuria.

  1. Age: Men older than 50 are more prone to hematuria
  2. Sex: While men are more likely to have stones or prostate infections, UTIs are quite common in women below 50s.
  3. Family history: though not hereditary, if kidney stones or cancers or infections are in the family, chances of developing hematuria also goes up.
  4. Medications: Aspirin, blood thinners, NSAIDs, and some antibiotics increase the chances of hematuria.
  5. Exercise: Long distance runners are shown to be more prone to developing hematuria.

Diagnosis: In addition to a physical exam, blood tests, imaging (CT scans and/or MRI) and cystoscopy might be required to confirm the diagnosis. Identifying the cause is extremely important as treatment would depend completely on the causative agent. Though hematuria is just one of the symptom, the underlying cause could have severe adverse effects on the whole body system.

Treatment: Whether it is an infection or enlarged prostate or kidney stone or tumour, once the cause is identified treatment is customised accordingly. Antibiotics for the infections, laser treatment for the stones, etc. are recommended.

If you see your urine turning slightly pink in colour, talk to your doctor immediately. Identifying the underlying cause and treating it will help solve the problem of hematuria.

In case you have a concern or query you can always consult an expert & get answers to your questions!
 

3388 people found this helpful

We are trying to convince for last 5 month but no conception, my wife's period was regular between 27 to 30 day ,and we are trying to intercourse between 12 to 18 day alternate day. We are married 4 years ago. And use only condom. Pls suggested me.

MBBS, MD - Obstetrtics & Gynaecology
Gynaecologist, Gurgaon
We are trying to convince for last 5 month but no conception, my wife's period was regular between 27 to 30 day ,and ...
Give time to yourself as a couple. If your wife is less than 35 years of age, then you should follow the method of alternate day intercourse b/w 12th to 18th day of cycle for another 6 months. If still your wife doesn't conceive then you should probably see a gynaecologist for further investigations.
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Smoking - Can It Lead To Bladder Cancer?

Urologist
Urologist, Gurgaon
Smoking - Can It Lead To Bladder Cancer?

As per myriad medical reports the world over, lung cancer is the number 1 killer cancer in the world, and one of the most common as well. This is closely followed by breast cancer. Yet, there are a number of types of cancer that can affect people all over the globe. Bladder cancer is one of the most common forms of cancer which takes place due to the abnormal growth of cells in the inner lining of the bladder.

There are many causes of bladder cancer, including genetics and smoking as well as exposure to a number of chemicals. Read on to know more about the same, and why it is imperative to give up smoking to avoid bladder cancer, or to treat it effectively.

  1. Smoking: Smoking and the use of tobacco is one of the most important causes of bladder cancer. It is a common misconception that smoking can only cause lung cancer. It can cause many types of cancer, including bladder cancer, because of the chemical exposure that happens when a person smokes. There are approximately 7,000 chemicals that are used when one cigarette is created, as per many studies and reports. These can have a harmful effect on the various organs of the body.
  2. Smoking and its effect on the bladder: So what happens to the bladder when you smoke? Cigarettes contain a number of chemicals, which are mostly carcinogenic. These get into the urinary tract and start to clog the inner lining of the bladder, because they do not get flushed out like normal waste with the urine. Eventually, these chemicals begin to erode the inner lining which leads to the accelerated and abnormal rate of cell growth in the region. This leads to the manifestation of a tumour, which may or may not be malignant.
  3. Urine and chemicals: When the chemicals from the cigarette begin to gather in the urinary tract, the bladder tends to remain in prolonged contact with this carcinogenic infested urine. This can lead to exposure to the elements, which can trigger abnormal cell growth and problems in the bladder. These high concentration levels of toxins in the urine eventually affect the functioning of the bladder.
  4. Smokers and non-smokers: As per many medical studies, those who do not smoke but have a family history of the condition as well as other environmental factors like exposure to certain types of chemicals in their workplace or other areas may be twice as susceptible to the growth of bladder cancer. But as per the same studies and medical reports, those who smoke, are actually four times more susceptible to bladder cancer.

Therefore, it is imperative to stop smoking so as to prevent the onset of this potentially fatal disease.

In case you have a concern or query you can always consult an expert & get answers to your questions!

3062 people found this helpful

My wife aged 25 years is suffering from PCOD problem. She is getting treatment from Gynecologist since 8 months. Nearly 10 tests have been done to diagnosis the exact problem like FSH, LH, TSH, Prolactin etc. And found results are within good limit. Still Eggs are not maturing due to multiple cysts around the ovary. She has been doing regular exercises, yoga etc. She is prescribed for Myocyst M tabs for 2 months twice daily. And after that, CCQ 100 tabs for D2 to D6 & Valest 2 tabs for D7 to D12 and USG (Ultrasound) suggested, which resulted good and provided Hucog HP 5000 injection. Again suggested for being in contact for next 5 days. What is the chance for her eggs maturation. Please suggest.

MBBS, MD - Obstetrtics & Gynaecology
Gynaecologist, Gurgaon
My wife aged 25 years is suffering from PCOD problem. She is getting treatment from Gynecologist since 8 months. Near...
With all the treatment your wife has taken, it is sure that she must have had formed good and mature eggs and that is why your doctor must have given her HUCOG injection. So, don't stress. Trust your doctor and your wife will conceive in due course of time. Since the eggs have formed in this cycle, it doesnot mean that she will conceive definitely in this cycle (chances of conception are 15--20%). So, don't stress and give time to yourself as well as the doctor and your wife will definitely conceive.
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