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.
Doctors in LivWell Clinic
Urinary Tract Infection (UTI) Treatment
Minimally Invasive Urology
Male Sexual Problems Treatment
Sexually Transmitted Disease (STD) Treatment
Female Sexual Problems Treatment
Prostate Laser Surgery
Transurethral Incision of The Prostate (TUIP)
Transurethral Resection of The Prostate (TURP)
Urinary Tract Obstruction Treatment
Male Infertility Treatment
Sexual Dysfunction Treatment
Renal ( Kidney ) Stones Treatment
Urinary Incontinence Treatment/Surgery
Hydrocele Treatment (Surgical)
Blood in Urine (Hematuria) Treatment
Urinary Tract / Bladder Stones Treatment
Male hypogonadism Treatment
Erectile Dysfunction Treatment
Men's Health Problems
Nephrectomy (kidney removal)
Infertility Evaluation Treatment
Assessment & Handling of High Risk Pregnancy cases(includes Deliveries)
Management of Menopause
Management of Heavy / Irregular periods
Evaluation of Abnormal Pap Smears
Evaluation and Management of pelvic pain
Management of Ectopic pregnancy
Management of Adenomyosis / Endometriosis
Treatment of Fibroid Uterus
Treatment of uterine / endometrial / fibroid polyps
Evaluation and management of Ovarian cysts / tumors
Gynecological Endocrinological Disorders
Management of Adolescent Gynecological conditions
Vaginal Infection Treatment
Treatment of Urinary Infections
Patient Review Highlights
During the complete polycystic ovary synDrome treatment program she always supported and motivated me. In the past i consulted so many doctors, but nobody was able to help me with my polycystic ovary synDrome, but she has helped me immensely. Initially the symptoms of polycystic ovary synDrome were not that severe but then it became worse. She is very courteous and behaves very aptly with elder patients. I searched this Nidhi Agarwal online and saw her reviews. Nidhi Agarwal doesn't just randomly prescribes medicines, but first properly diagnoses the problem. I am so much benefitted with her treatment, that i am perfectly fine now.
I was suffering from thyroid disorders during pregnancy and I did not want to transfer the same problem to my baby. I consulted Dr Nidhi, she is a best gynaecologist in the city. Even in case of emergency, the staff is always willing to help. Over the period of time the thyroid disorders treatment has helped me a lot. I am so much benefitted with her thyroid disorders treatment, that i am perfectly fine now. Her guidance has helped me immensely with my situation.
Finally with his lithotripsy, I am completely cured from my kidney stones. I was quite depressed due to my condition, but Dr Rajiv Goel guided me to change my attitude. Someone from the office, referred us his name. In the past i consulted so many doctors, but nobody was able to help me with my issue, but he has helped me immensely. Even in case of emergency, the staff is always willing to help.
I feel strange that I am suffering from male sexual problems. It's been more than a year that I was experiencing male sexual problems. I consulted Dr Rajiv Goel, he is so nice that they even at odd hours one can call him in case of emergency. I am really grateful as his male sexual treatment has give me a ray of hope. His treatment suited me the best and now I am fine.
Finally with her treatment, I am completely cured from the no periods problem. Dr Nidhi Agarwal has in depth knowledge and ensures that she explains the problem in detail. The friendliness of staff is the best in the LivWell Clinic. I was quite depressed due to my condition, but my she guided me to change my attitude.
I was shocked to experience the symptoms of male sexual problems. But the treatment Dr Rajiv has given me, benefitted me to great extent. He is not just friendly, but also is very motivating. Thanks to Dr Rajiv for the perfect advice. He has in depth knowledge and ensures that he explains the problem in detail.
I was trying to conceive but was not able to , so my husband took me to Dr Nidhi. She is one of the best gynaecologist in the city. My previous experiences were not so good, but she has completely changed my opinion as she is very helpful and humble. I am completely satisfied with the results of my treatment.
I have had this irregular periods from quite some time. She is very professional and is a really patient listener. It's been more than a year now, and I have noticed considerable change in myself after her treatment. Even though there was a long queue, still the staff was very pleasant.
I had wonderful experience with dr Nidhi Agarwal especially the nursing staff at LivWell Clinic in gurgaon while taking a treatment to avoid pregnancy. they took good care of me and treated me like a family member. doctor is very efficient and she is very soft spoken.
I first went to Dr NIdhi Aggarwal when I was suffering from abdominal pain after my pregnancy, I visited at her clinic Dr Nidhi Aggarwal's Clinic which is located in New Delhi and I found her advice satisfactory and valuable.
I consulted dr Nidhi agarwal for homeopathy treatment as i was not getting any relief from allopathy treatment. She is a very experienced doctor. So far the treatment is good and I have witnessed signs of improvement.
I found the answers provided by the Dr. Nidhi Agarwal to be very helpful, well-reasoned and helped me improve my health. Thank You Doctor Nidhi.
I found the answers provided by the Dr. Nidhi Agarwal to be very helpful and caring. caring
I found the answers provided by the Dr. Nidhi Agarwal to be very helpful. Thanks Doctor
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Dr. Nidhi Agarwal provides answers that are knowledgeable. Thank you so much mam..
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Dr. Nidhi Agarwal provides answers that are well-reasoned. Thank you.
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!
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.
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.
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!
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.
- 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.
- 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.
- 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.
- 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.
- Age: Men older than 50 are more prone to hematuria
- Sex: While men are more likely to have stones or prostate infections, UTIs are quite common in women below 50s.
- Family history: though not hereditary, if kidney stones or cancers or infections are in the family, chances of developing hematuria also goes up.
- Medications: Aspirin, blood thinners, NSAIDs, and some antibiotics increase the chances of hematuria.
- 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!
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.
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.
- 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.
- 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.
- 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.
- 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.