Doctor in Sanjeevanee Hospital
Treatment of Pregnancy and related Disorder
Treatment of Irregular Periods
Management of Pregnancy
Treatment of Ovarian Cysts
Management of Pregnancy Query
Treatment of Painful Periods
Avoiding Pregnancy Procedures
Treatment of Heavy Periods
Treatment of Polycystic Ovary Syndrome
Treatment of Breast Pain
Treatment of Vaginal Discharge
Treatment of Miscarriage
Treatment of Vaginal Itching
Treatment of Fertility
Treatment of Delayed Periods
Treatment of Vaginal Infection
Management of Fertile Period
Management of Menopausal Disorders
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Patient Review Highlights
There is no better feeling than the movement of life inside you. Bearing a baby is no easy feat. Caring for your health before you become pregnant is very important for you and your bundle of joy. Preconception care and counseling will empower you to gear up for pregnancy. The goal of preconception counseling is to check for potential risks to you and your baby during pregnancy and address them well in advance before you get pregnant.
It is all about becoming your healthiest self both physically and mentally before you take the plunge. Planning for your pregnancy will help you make healthy choices and you can start out the right way by getting a preconception counseling appointment with your health care provider.
What happens at a Preconception Counselling?
It is the perfect time for you to discuss with your doctor about any concerns you have in your mind. Here are the things that are most likely to be discussed:
- Reproductive History – Your history related to your reproductive health can include your previous pregnancies, menstrual history, contraceptive use, vaginal infections or sexually transmitted diseases.
- Medical History – This constitutes of any health problems you have now and can get in under control before you get pregnant. Also, your family health history including diabetes, hypertension and more can be discussed.
- Surgical History – Have you had any surgeries done before for any complications? It is very important to let you gynecologist know about the same.
- Current Medications – Have you taking any prescribed or over the counter medicines, supplements or herbal medicines? If yes, it is best to speak with a doctor as certain medicines can lead to birth defects so talk to your doctor about them.
- Home and Workplace Environment – Are you facing any hazards from environmental factors that will deter your ability to get pregnant or maintain a healthy pregnancy?
- Weight Management – It is good to have an ideal weight before you get pregnant to avoid complications during pregnancy.
- Lifestyle Factors – Your diet, caffeine intake, exercise and other lifestyle habits should be discussed. The goal is to help you stop any unhealthy habits that could stand in your way towards a healthy pregnancy.
- Prenatal Vitamins – Even before you conceive, it's good to take these vitamins in order to prevent birth or neural tube defects. Your doctor will help you choose the right one at the right dosage.
Tests Performed During Preconception Counselling
- Physical Exam – Tests like pap smear, pelvic exam and more can be done to assess where you stand.
- Lab Tests – Blood test to detect any abnormalities can be taken into account
- Menstrual Cycles – It is good to chart your menstrual cycles to help you detect ovulation and determine the time to get pregnant
In case you have a concern or query you can always consult an expert & get answers to your questions!
An STD or sexually transmitted disease is usually an infection which spreads from one person to another during sexual contact. Some STDs can also be transferred through touch, since they spread by skin contact. People hardly like to talk or discuss about STDs, but it is very important to rule out the possibilities of STD. Whether one likes it or not, if STD testing is ignored, then it can lead to long-term consequences.
Why STD Testing is Important?
Often STDs have no signs and symptoms, and the only way to know that are you suffering from an STD is to get tested for it. So it is a good idea to get yourself tested, as you never know if you might have STD even though you don't show symptoms. Also, when STDs are diagnosed, most of them can be cured.
Consequences of not Getting Tested
If one has STD and is not getting tested for the same, then it could lead to health problems which can cause permanent damages or might prove to be fatal. Some of the problems are:
- Undiagnosed and untreated STDs can lead to damaged reproductive system, leading to sterile men and women.
- Chlamydia, if untreated can lead to epididymitis and shrinkage of testicles and infertility in men. It also leads to pelvic inflammatory disease. But, good news is, it can be treated easily.
- Syphilis can make a person blind and deaf, and can also be passed on to babies.
- Gonorrhea, which can also be treated easily with antibiotics, can lead to infertility or death if untreated.
- Even HIV/AIDS if diagnosed in early stages can enable the patient to lead a normal life and does not mean only death, contrary to conventional perceptions.
Symptoms of STD
While, gonorrhea, chlamydia and human papilloma virus (HPV) have no symptoms, the common symptoms of STDs might vary.
- In women, the common symptoms are pain and burning sensation during urination, blood in vaginal discharge as also abnormal vaginal discharge, abdominal pain, blisters, warts, and swollen glands.
- Men often experience inflammation of the testicles, prostate, sores, fever, urethral discharge and pain during urination.
If these symptoms are observed, it is vital to get tested for STDs. Also, the best way to protect your partner is not to practice unsafe sex and to refrain from the same until diagnosed and treatment is complete.
Getting yourself tested for STD is also beneficial, as it can prevent against complications like cancers and infertility. The standard STD panel of tests consists of Herpes IgG antibody and HIV antibody blood tests, along with a blood test for syphilis antibody and DNA urine test for gonorrhea and Chlamydia. If you wish to discuss about any specific problem, you can consult a Gynaecologist.
Most women attain menopause between the ages of late 40s and early 60s, the average age being about 51. This is an important milestone in a women's gynecological history. One major change is altered female hormone levels, and this leads to a lot of physiological changes. From hot flashes to mood swings, there is also increased predisposition to osteoporosis and uterine cancer.
If you have not had your menstrual cycles for close to 12 months, chances are you are into menopause. So, that means absolutely no vaginal bleeding anymore whatsoever. However, if you experience bleeding, even spotting, be on the alert. It is not normal and needs to be examined, and if required, diagnosed and treated.
Postmenopausal bleeding or PMB, as it is popularly called, can be due to a variety of reasons. While it could be something as trivial as inflammation of the uterine or vaginal lining, it could also be an indication of more severe issues like cancer.
- Atrophic vaginitis: Decreasing hormonal levels lead to increased dryness and therefore inflammation of the vaginal and uterine tissue. This is one of the common causes of bleeding after menopause.
- Endometrial atrophy: Also caused by lower hormone levels, the lining of the body of the uterus gradually thins down and can get inflamed.
- Polyps: Noncancerous growths in the uterus, cervix, vulva, or vagina can also lead to bleeding.
- Infections: General infection of any area along the uterine tract could lead to occasional bleeding.
- Cancers: Though only 1 in 10 PMB cases turn out to be cancers, the prognosis improves with early diagnosis and intervention.
Diagnosis: As repeated above, reach out to your doctor if you notice postmenopausal bleeding. Diagnostic methods could include the following:
- Physical examination such as Pap smear
- Transvaginal ultrasound
- Endometrial biopsy
- Dilatation and Curettage
Treatment: Needless to say, this would depend on the diagnosis. For very minor cases with diagnosis like altered hormone levels, no treatment may be required other than modification of the hormone replacement therapy. For endometrial atrophy and atrophic vaginitis, use of estrogen creams and pessaries would be sufficient. Polyps would require removal followed by cauterization (application of slight heat) to stop the bleeding.
Cancer: This would depend on the type and location and require a combination of chemotherapy and surgery. Removal of the uterus also may be required in some cases. So, if you have had bleeding of any sort after a year of menopause, do not ignore it. If you wish to discuss about any specific problem, you can consult a Gynaecologist.
Once the reality of the positive pregnancy test sets in, dreaming about the yet-to-arrive begins. Curiosity about gender, options for names, ways to manage, shopping ideas, etc., begin to get discussed. And then totally out of the blue the news comes that there is a miscarriage. This is one of the most depressing phases. It is very important for the family to be around and support each other. While the entire family is upset and hurt over the news, the mother needs most care as there is just not emotional but a huge physical component also to the episode. On the other hand, remember that miscarriages are extremely common, and is no indication of a fertility issue.
The first step would be to diagnose and confirm the miscarriage. After that, depending on whether it was complete or incomplete, some medical intervention might be required. In most cases, medications like misoprostol are given to expel the uterine contents. These help by clearing out the contents in about a couple of days' time. In some cases, a D and C might be required if your doctor suspects that medication will not suffice. This also helps identify if there is any issue in the uterus that could have caused the miscarriage.
While the above takes care of the physical part, the emotional component also requires cautious management. Needless to say, this is trickier than the earlier one.
- Mourn to your heart's content - When you have nursed a life within you and have lost it, it is very normal to cry for its loss. There would be a mix of emotions - shock, denial, confusion, anger, grief, depression etc. Take some solace from that fact that this is nature's way of removing unhealthy fetuses.
- Get someone to talk to - Need not be your husband, but anybody whom you can talk to without having to watch words. A sibling, a good friend, a close relative - your choice. Make sure you don't pick ones who will judge and sympathize with you. More than sympathy, you need someone understanding and knowledgeable.
- Socialize more - As you would have kept to yourself post your positive test, use this time to socialize more and meet friends whom you have not regularly been in touch with. Close family members, your children (if you already have), society groups, movie groups, etc., help to a great extent.
- Formal medical counseling: If you are not able to cope with your regular circle of family and friends, try seeking professional advice from counseling.
- Spirituality - Whether you believe in temple or churches, spend some time there. Involve in some religious activity if you would like, this helps very often.
As much as it is painful and traumatic, it is not very uncommon or unnatural. Get back on your feet, the sooner you do, the better. If you wish to discuss about any specific problem, you can consult a Gynaecologist.
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 afew tips that will help you deal with it.
- Set an exercise routine: Exercising not only helps you maintain weight but also helps dealing 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 you 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 regulates 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.
In case you have a concern or query you can always consult an expert & get answers to your questions!
Uterine fibroids, also known as leiomyoma or myoma, are benign growths on the uterus, occurring mostly during the years of childbearing. Few of the common symptoms of fibroids are leg pain or backache, constipation, difficulty in emptying the bladder, frequent urination, pain or pressure in the pelvic region, menstrual periods stretching over a week and excessive menstrual bleeding.
Certain genetic changes of the uterus which are different from the ones normally present in the muscle cells of the uterus can cause this disorder.
Certain hormones such as progesterone and estrogen that prepare the body for pregnancy are even responsible for triggering the development of fibroids.
Substances which help the body maintain its tissues trigger fibroid growth as well.
Family history, excessive consumption of alcohol and red meat while going low on foods such as dairy products, fruits, green vegetables and vitamin D, obesity, usage of birth control pills and early onset of the menstruation cycle are other factors that may escalate the risks of one suffering from fibroids.
Be careful and take a closer look: Fibroids are fundamentally non-cancerous and they hardly interfere with pregnancy. Often, they do not exhibit notable symptoms and are prone to shrinkage after menopause. Hence giving them and yourself some time might be the best option.
Medications generally aim at the hormones controlling the menstrual cycle and treating symptoms such as pelvic pressure and excessive menstrual bleeding. However, they do not treat fibroids completely but work towards contracting them. They include-
Gonadotropin-releasing hormone (Gn-RH) agonists to block estrogen and progesterone production
Tranexamic acid to ease excessive menstrual periods
Progestins or oral contraceptives to regulate menstrual bleeding
Nonsteroidal anti-inflammatory drugs (NSAIDs) to ease pain associated with fibroids
Surgeries to Treat Fibroids:
Depending on symptoms and whether medical therapy has failed, the patient may have to undergo surgery. The following surgical procedures may be considered:
Hysterectomy: Removing the uterus. This is only considered if the fibroids are very large, or if the patient is bleeding too much. Hysterectomies are sometimes an option to prevent fibroids coming back.
Myomectomy: Fibroids are surgically removed from the wall of the uterus. This option is more popular for women who want to get pregnant.
UAE (Uterine artery embolization): This treatment cuts off the fibroid's blood supply, effectively shrinking the fibroid.
Magnetic-resonance-guided focused ultrasound surgery: An MRI scan locates the fibroids, and sound waves are used to shrink the fibroids. If you wish to discuss about any specific problem, you can consult a gynaecologist.
'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 a normal delivery is expected.
Polycystic Ovarian Syndrome or Disease (PCOS) is a very common condition, wherein there are multiple cysts in the ovaries. As a result, there are many changes which the body undergoes and it is not limited to the gynecologic system. A woman with PCOS may also find it difficult to conceive, and so, once she is pregnant, precautions are essential to ensure there are no complications.
Pcos predisposes women to diabetes, hypertension, obesity, cardiovascular complications, lipid metabolism disorders, uterine cancer in long run. Some of them are listed below:
- Preeclampsia: When the blood pressure readings are high during pregnancy, it is known as preeclampsia. It brings with it a whole lot of complications including the need to cesarean section (c-section), premature birth, etc. So, it is best avoided, and diet can help to some extent.
- Diabetes: Gestational diabetes which manifests as higher sugar levels only during the pregnancy is very common in women with PCOS. The increased hormone levels in PCOS increase insulin resistance, thereby increasing sugar levels. This needs to be managed through a combination of diet, exercise, and lifestyle changes.
- Preterm labor: Women with PCOS are at a slightly higher risk of premature labor.
- Weight-related issues: PCOS leads to weight gain, and this could be a problem during pregnancy. It is essential to discuss with the doctor as to what would be a good weight range and stay within that range throughout pregnancy. Weight gain brings with it a host of complications and so best avoided.
With PCOS, during pregnancy, strict cautious diet planning can help in avoiding complications and allow for an easier pregnancy. Though they may not solve every problem associated with PCOS, dietary modifications can have a significant effect on the overall health and well-being. Listed below are some easy-to-make changes:
- Increase consumption of fibres like greens, nuts, pumpkin, berries, whole grains, almonds, etc. are included. This ensures that digestion is a prolonged and gradual spike in blood sugar levels.
- Increase protein-rich foods like soya, tofu, eggs, and chicken, which help in avoiding binging. They are light on the stomach and help in weight management.
- Foods which are generally anti-inflammatory including tomatoes, olive oil, spinach, fresh fruits, and omega-3 fatty acids help in controlling blood pressure and cholesterol levels.
- Supplements to include omega-3 fatty acids, prenatal vitamins, vitamin D, and calcium if required ensure that the baby gets the required nutrients for optimal growth.
What to avoid:
Anything that can spike up calories and is of low nutritional value should be avoided.
- Avoid whites – pasta, rice, and bread
- Baked and processed foods
- Candies, chocolates, snacks
- Salty and spicy fried snacks
- Aerated drinks and soda
PCOS in pregnancy presents a combination risk, and dietary changes and weight management are essential for a safe pregnancy. If you wish to discuss about any specific problem, you can consult a gynaecologist.
A hysterectomy is a surgical procedure to remove a woman's uterus. The uterus, also known as the womb, is where a baby grows when a woman is pregnant. The uterine lining is the source of menstrual blood.
You may need a hysterectomy for many reasons. The surgery can be used to treat a number of chronic pain conditions as well as certain types of cancer and infections.
A woman may have a hysterectomy for different reasons, including:
- Uterine fibroids that cause pain, bleeding, or other problems
- Uterine prolapse, which is a sliding of the uterus from its normal position into the vaginal canal
- Cancer of the uterus, cervix, or ovaries
- Abnormal vaginal bleeding
- Chronic pelvic pain
- Adenomyosis, or a thickening of the uterus
- Hysterectomy for noncancerous reasons is usually considered only after all other treatment approaches have been tried without success.
Types of Hysterectomy:
Depending on the reason for the hysterectomy, a surgeon may choose to remove all or only part of the uterus. Patients and health care providers sometimes use these terms inexactly, so it is important to clarify if the cervix and/or ovaries are removed:
In Partial or supracervical hysterectomy, the upper portion of the uterus is removed, leaving the cervix intact.
Complete or total hysterectomy involves the removal of both the uterus and the cervix. This is the most common type of hysterectomy performed.
Hysterectomy with bilateral salpingo-oophorectomy is the removal of the uterus, cervix, fallopian tubes, and ovaries.
Radical hysterectomy is an extensive surgical procedure in which the uterus, cervix, ovaries, fallopian tubes, upper vagina, some surrounding tissue, and lymph nodes are removed.
Hysterectomy Surgical Procedures
Traditionally, hysterectomies have been performed using a technique known as total abdominal hysterectomy (TAH). However, in recent years, two less-invasive procedures have been developed: Vaginal hysterectomy and Laparoscopic hysterectomy:
- Total abdominal hysterectomy (TAH): In a total abdominal hysterectomy (TAH), the surgeon makes an incision approximately five inches long in the abdominal wall, cutting through skin and connective tissue to reach the uterus. This type of surgery is especially useful if there are large fibroids or if cancer is suspected. Disadvantages include more pain and a longer recovery time than other procedures, and a larger scar.
- Vaginal hysterectomy: A vaginal hysterectomy is done through a small incision at the top of the vagina. Through the incision, the uterus (and cervix, if necessary) is separated from its connecting tissue and blood supply and removed through the vagina. This procedure is often used for conditions such as uterine prolapse. Vaginal hysterectomy heals faster than abdominal hysterectomy, results in less pain, and generally does not cause external scarring.
- Laparoscopic hysterectomy: During a laparoscopic hysterectomy, your doctor uses a tiny instrument called a laparoscope. A laparoscope is a long, thin tube with a high-intensity light and a high-resolution camera at the front. The instrument is inserted through incisions in the abdomen. Three or four small incisions are made instead of one large incision. Once the surgeon can see your uterus, they will cut the uterus into small pieces and remove one piece at a time.
A hysterectomy is a major decision that you should take after careful consultation with a doctor. You should understand the reason for the operation, the benefits and risks and the alternatives to a hysterectomy. If you are unsure, discuss the issue with your doctor or obtain a second opinion.