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Dr. Nileema Deshmukh

Gynaecologist, Mumbai

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Dr. Nileema Deshmukh Gynaecologist, Mumbai
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I believe in health care that is based on a personal commitment to meet patient needs with compassion and care....more
I believe in health care that is based on a personal commitment to meet patient needs with compassion and care.
More about Dr. Nileema Deshmukh
Dr. Nileema Deshmukh is a popular Gynaecologist in Andheri West, Mumbai. She is currently practising at Heena Nursing Home in Andheri West, Mumbai. Save your time and book an appointment online with Dr. Nileema Deshmukh on Lybrate.com.

Find numerous Gynaecologists in India from the comfort of your home on Lybrate.com. You will find Gynaecologists with more than 34 years of experience on Lybrate.com. You can find Gynaecologists online in Mumbai and from across India. View the profile of medical specialists and their reviews from other patients to make an informed decision.

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Heena Nursing Home

Flat No A 102, Persian Apartments, V P Road, Andheri West,Landmark:-Opposite Narco Shopping Center, MumbaiMumbai Get Directions
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Medico Legal Aspect of Sex Therapy

MD-Dermatology, MBBS
Sexologist, Pune
Medico Legal Aspect of Sex Therapy

 

Medico legal aspects of sex therapy

Introduction

Sex and human sexuality are sensitive subject. To deal effectively with any problem of human sexuality, one has to constantly evaluate its merits and demerits from social, scientific, moral, ethical and most importantly from the legal angle. Following are some of the guidelines for therapist to keep in mind while dealing with clients with sexual problems.

Consent

Taking informed and expressed consent is of utmost importance while managing any patient. Examining and / or treating a patient without consent would amount to assault and battery which is punishable under criminal law irrespective of absence of negligence or successful outcome of treatment. The consent should be free willed, informed, intelligent, specific and express. Person giving consent should be competent to do so, failing which, consent should be obtained from the lawful guardian of the patient (in cases of minor and/or mentally retarded).

Examinition of a female client

Besides obtaining a valid consent, in case of female patient, the therapist should always have a female assistant present when examining a female patient this is important for the therapist in order to protect himself from a possible charge of indecent behaviour molestation or even sexual offence like rape ect. Being llevelled against him. Mere presence of husband or any male companion of the female patient is not enough. A sex therapist, in particular, is most vulnerable and therefore should be most careful.

Use of surrogate partners

Use of surrogate partners for sex therapy is questionable both ethically as well as legally. Sexual involvement of the therapist is universally accepted as unethical. There have been a number of cases where the therapists themselves, having acted as surrogates, have been punished for sexual molestion of their patients. It may also invite a criminal charge of adultery in some countries, including india. There are cases on record where the therapists have been charged with and convicted of rape.

Unlike some other countries, the socio cultural set up in india is different. The laws governing sexual behaviour are neither liberal nor evolved as much as in some of the western countries. Besides, surrogacy is likened to prostitution by many. Even if one were to consider surrogate partner as a therapist, then the ethical code prevents a sexual relationship with a client. Moreover, there is every possibility of a disease being transmitted. Particularly the hiv infection, in view of sex with multiple partners by a surrogate person.

Therapist should have uppermost in mind the special values of intimacy and love that our culture teaches us to nurture.

Professional competency

It is the ethical responsibility of every sex therapist to maintain high standards of professional competence and integrity. Competence without integrity or integrity without competence is an unsatisfactory compromise of professionalism. It is most important to protect the public and the other professionals from persons who represent themselves as sex therapists who are in fact lacking in competence and intergrity.

Competence in another primary discipline such as psychology, psychiatry or counselling is not equivalent to competence in sex therapy.

A sex therapist should possess adequate knowledge of the following:

 

1. Sexual and reproductive anatomy and physiology.

2. Developmental sexuality from a psychobiological point of view.

3. Marital, family and interpersonal relationship and socio-cultural factors in sexual values

4. Physiological and medical factors that may influence sexual functions such as pregnancy, contraception and fertility, illness, disability, medications.

5. Multimodel techniques and theory of sex therapy and psychotherapy.

6. Pharmacology of the medications used to treat sexual dysfunctions particularly with respect to their adverse effects and interactions with the drugs being consumed for other ailments.

7. Ethical issues in sex therapy and principles of evaluation and referral.

8. Laws related to sexual behaviour.

 

 

Points to bear in mind

 

all forms of sex therapy which violate the local laws should be handled with care recommending oral sex as a part of therapy is violative of section 377 of the indian penal code which deal with unnatural sexual offences.

the hippocratic oath forbids the physician to take advantage of the therapeutic context in order to engage in either homosexual or heterosexual relationship.

it is a universal rule that whenever dealing with reproductive functions is involved, express consent of both the spouses should be obtained.

proof of competence is the ability to provide objective and responsible services to the clients.

there does exist a potential liability under the laws of the land prohibiting consensual conduct such as prostitution, fornication, lewd and lascivious behaviour and adultery which might arise from therapeutic or non- therapeutic sex research activities.

sex between therapist and client is always unethical. No matter how therapeutic the rationale might appear, there is no justification for a therapist having sex with a client. The purpose of sex therapy is to improve function, not to change values or beliefs of the client.

2 people found this helpful

My menstrual period is irregular last time I had a period was October of 2016 I'm not pregnant, having irregular menstruation has been my situation ever since I started to have I'm just concern with my health I'm actually thinking that big part of it is the stress that I'm getting at work I just need an advice of what do I need to do.

MBBS
General Physician, Cuttack
My menstrual period is irregular last time I had a period was October of 2016 I'm not pregnant, having irregular mens...
It could be due to hypothyroidism or PCOS. Do a thyroid function test to rule out hypothyroidism 1.In PCOS (polycystic ovarian syndrome )many small cysts appear in ovary-causing hormonal imbalance and .there is production of excess Testosterone. Diet rich in Omega 3 Fatty acid reducece excess Testosterone and can be used in the treatment 2.They secrete more androgen 3.The symptoms are weight gain, acne, decreased ovulation, irregular period, infertility, depression, extra facial and body hair, hair loss from scalp, insulin resistance causing Diabetes. 4.it is genetically inherited, runs in families 5.it can be diagnosed by pelvic laparoscopy/vaginal ultrasound. 6.Treatment-surgery/anti androgen therapy 7.consult gynecologist for advice and treatment.
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I am 24 year old female. I experience excruciating pain during periods. I have had multiple treatments for the same but none seemed to work (even if they do it is only temporary). As soon as I stop medication it all comes back. In december 2013 I was diagnosed with pcod. So I continued my medication for about a year. The medication regulated my periods and the problem was gone. But now that I have stopped taking meds, I am again getting delayed and painful periods. Please help me out. Is there any permanent solution to this problem? if yes, what is it?

Advanced Aesthetics
Ayurveda, Gulbarga
You need to consult me privately. I can prescribe some tests to identify the causes and treat accordingly. Ovarian cysts are small fluid-filled sacs that develop in a woman's ovaries. Most cysts are harmless, but some may cause problems such as rupture, bleeding, or pain. Moreover, surgery may be required in certain situations to remove the cyst (s). It is important to understand the function of the ovaries and how these cysts may form.
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I am having heavy pain at the time of monthly period before 3 days & continues to 5 days, bleeding also huge. I am suffering from 2 to 3 years, kindly help to solve this problem.

MD-Ayurveda, Bachelor of Ayurveda, Medicine and Surgery (BAMS)
Sexologist, Haldwani
I am having heavy pain at the time of monthly period before 3 days & continues to 5 days, bleeding also huge. I am su...
Hello lybrate-user- pain during menses is due to improper tone of uterus muscles. Use dashmoolaristha 2 tsp twice daily for 10 days before menses. This single medicine will cure all of your menstrual problems (do not use the medicine more than ten days as the body will become habitual to it and will not respond quickly)
3 people found this helpful
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Probiotics as a Health Supplement

Masters Of Science In Dietetics And Food Service Management Msc. (DFSM), Certified Diabetes Educator (CDE), Advanced Clinical Nutrition Program, Post Graduate Diploma In Clinical Nutrition And Dietetics PGD, Bachelors Degree In Applied Nutrition Bhsc
Dietitian/Nutritionist, Mumbai
Probiotics as a Health Supplement

The human body consists of a wide variety of bacteria which are either good or bad for your body. The general image of bacteria is that they only cause harm to your body, but this is not the actual scenario and there are many types of good bacteria as well which are actually beneficial for your health. Probiotics are health supplements that usually contain live bacteria to be consumed in solid or liquid form. One of the most important functions of probiotics is that they help in ensuring a functional and healthy digestive system.

Why are they beneficial for you?

Whenever you experience a fall in the good bacteria count inside your body due to activities like taking heavy antibiotic medications on a regular basis, then probiotics come into the picture. Probiotics actually reverse the change caused by antibiotics and raises the good bacteria inside your body. Additionally, probiotics also help in maintaining a proper balance between the good and the bad bacteria inside your body.

Types

All the probiotics are classified into 2 broad groups, but you should always consult your dietician before choosing a probiotic for yourself.

  • Lactobacillus - This is the most common form of probiotic, which is usually present in fermented foods and yoghurt. It is most beneficial in cases where people cannot digest lactose (the sugar present in the milk consumed).
  • Bifidobacterium - This is the second category of good bacteria and it mostly regulates and speeds up the activities related to your digestive system. It is usually found in most of the dairy products and it helps to cure a disorder called Irritable Bowel Syndrome (IBS).

In order to ensure safe usage of probiotics, you should always consult your doctor before opting for such a health supplement.

If you would like to consult with me privately, please click on 'Consult'.

Tip: Symptoms and Risk Factors Associated with Bulimia Nervosa

3890 people found this helpful

How long a ipill can suppress the ovulation. When it was given 7 days before ovulation? please help me. Tnaku.

MD - Obstetrtics & Gynaecology
Gynaecologist, Mumbai
How long a ipill can suppress the ovulation. When it was given 7 days before ovulation? please help me. Tnaku.
It will work only within 5 days of sex. I-pill if taken within 24 hrs if 95% effective. On second day it is 85% effective. Likewise its efficacy keeps going down each day. It will work well if it was given 7 days before ovulation.
1 person found this helpful
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Mere period jish din khatam hua ushi din SE next period starts hone tak din me 3 SE 4 bar sex karne ke bad v hum pregnant nahi hua or jab mera period hota hai to pahle blood ke santh aunde jaisa niklta tha lekin wo ab lagbhag 6 SE 7 mahine SE nahi niklta mujhe Janna hai ki kya mai maa ban Sakti hu ya nahi mai ma banna chahti hua ishliye please help me.

MBBS, MD - Obstetrtics & Gynaecology, FMAS, DMAS
Gynaecologist, Noida
Mere period jish din khatam hua ushi din SE next period starts hone tak din me 3 SE 4 bar sex karne ke bad v hum preg...
Hello, you should follow sex during your fertile period from day 12-20 in a 28-30 days cycle to increase your chances of pregnancy. Also get your husband's semen analysis done to check for sperm count and quality.
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I haven’t had periods since the past 2 months And I am not pregnant. What could be the Reason?

BHMS
Homeopath, Faridabad
I haven’t had periods since the past 2 months
And I am not pregnant. What could be the
Reason?
Hello, you might be suffering with PCOD. Polycystic ovary syndrome (PCOS) occurs when very small cysts (small, fluid-filled sacs) develop in the ovaries. The usual symptoms of PCOS are light periods or no periods at all. This is because, in women with PCOS, ovulation (the release of an egg) may not take place as often as normal. You should opt Homoeopathic treatment, it has cure for PCOS. Treatment is based on totality of symptoms and constitution. It takes time but resolve the disease by root.In pcos first we target to get your periods back to normal. So get an ultrasound abdomen test done and share the report.
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I am 39 years old woman. Since two months my periods have become very scanty. I am getting very worried as I will get married once again next year and I want to conceive a child. Does getting scanty period is menopause? please help me.

Advanced Aesthetics
Ayurveda, Gulbarga
After reaching a certain age, a woman's ovaries stop making eggs and there is less production of hormones like estrogen and progesterone that regulate menstruation and fertility. Gradually, menstrual cycles become irregular and eventually stop. Menopause is confirmed when a woman has no period for 12 consecutive months. This process normally happens between ages 45 and 55 your age is 39 not to worry any queries inform me.
2 people found this helpful
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Hello I am trying for baby but worrying about my weight how I can control in this time? And precautions to take weight gain in pregnancy. Suggest me for proper plan.

MBBS
General Physician, Chandigarh
Hello I am trying for baby but worrying about my weight how I can control in this time? And precautions to take weigh...
Once you conceive you are going to gain weight as another life is growing inside you but with proper diet and regular exercises you can control your weight in pregnancy also and once you deliver the baby you can regain your original weight back again by controlling your diet and exercises.
1 person found this helpful
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Last year I was carrying 2 months & has to abort because there was no cardiac activity found & now I have been trying to conceive & I'm not able to so which is the right time to have intercourse to conceive has I'm having scanty flow.

DGO, MD, MRCOG, CCST, Accredation in Colposcopy
Gynaecologist, Kolkata
Last year I was carrying 2 months & has to abort because there was no cardiac activity found & now I have been trying...
If you have regular 28 days periods then the best time to have intercourse is mid cycle around day10 to day 17 of cycle.
1 person found this helpful
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I have a break in my periods. I have got my last periods on Dec 8 2014. I am 48 years old. .Past one year my periods are irregular. Do i have to go to doctor , or shall i wait and see. I need your support and please tell me what to do ?

DNB (Obstetrics and Gynecology)
Gynaecologist, Bangalore
You may be pre-menopausal. None the less, it is advisable to see your doctor once for a general check-up and PAP Smear.
1 person found this helpful

hello mam. I am very stressed because my monthly cycle is not in its proper form. Last month I had taken pills prescribed by my doctor then I got my periods but again this month my periods are not proper I got only one day period. Pls help me my age is 24.

MD- Ayurveda
Ayurveda, Ujjain
hello mam. I am very stressed because my monthly cycle is not in its proper form. Last month I had taken pills prescr...
Take Rajapravartni vati 2-2-2 three time in a day Eva care syp 20 ml twice in a day with lukewarm water after meal atleast 1 month Do C.B.C TEST REPORT TO ME LATER.
1 person found this helpful
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It's about 3 monts of pregnancy and feeling fever with some cold. We have Nozee tablet which containg 500mg of paracitomol. Can we take this, if yes at what duration and amount. Waiting for reply

MD - Obstetrtics & Gynaecology
Gynaecologist, Mumbai
Yes u can take it safely. But not empty stomach and not more than twice a day as it contain cetrizine. It also contain Phenylephrine which is only recommended for use during pregnancy when benefit outweighs risk. So I suggest u take medicines without phenylephrine
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What would be the symptoms in a young girl before going to start her first menstrual cycle?

BHMS
Homeopath, Faridabad
What would be the symptoms in a young girl before going to start her first menstrual cycle?
Girls usually start to go through puberty between the ages of 8 and 13. Their bodies and minds change in many ways. Hormones kick off changes like growth and breast development. About 2 to 2½ years after a girl's breasts begin to develop, she usually gets her first menstrual period. About 6 months or so before getting her first period, a girl might notice an increased amount of clear vaginal discharge. This discharge is common. There's no need for a girl to worry about discharge unless it has a strong odor or causes itchiness. When a girl first gets her period, doctors call it menarche. Menarche doesn't happen until all the parts of a girl's reproductive system have matured and are working together.
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I have pcod in stage 1 and pelvic endometriosis in stage 3.please help me to know can I conceive? M married n 7 months over. I hav too much pain during periods. Is there any problem for pregnancy and also tell me process wat to do?

Bachelor of Ayurveda, Medicine and Surgery (BAMS)
Sexologist, Lucknow
I have pcod in stage 1 and pelvic endometriosis in stage 3.please help me to know can I conceive? M married n 7 month...
At present you take syp ashokarista 3tsf two times with water this ayurvedic medicine helps you. But for further treatment of endometriosis and pcod you consult me privately through Lybrate and take My ayurvedic treatment for this.
1 person found this helpful
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Vitamin D and Calcium

MBBS, Diploma in Child Health
Pediatrician, Hyderabad
Vitamin D and Calcium

What are Vitamin D and Calcium?

Vitamin D (a hormone) and calcium (a mineral) are nutrients that sustain healthy bones. They are also needed for:

  • Muscle movement

  • Nerve communication

  • Absorption of calcium and phosphorous (vitamin D)

  • Immune system responses (vitamin D)

  • Signaling between cells (calcium)

  • Hormonal secretion (calcium)

  • Blood vessel flow (calcium)

Without enough vitamin D or calcium, your parathyroid glands compensate by producing too much of their hormone, a condition called hyperparathyroidism. That can lead to bone weakening (osteoporosis) and increased fracture risk. 
Other problems from calcium and vitamin D deficiencies include:

  • Skeletal deformities (rickets) in children ages 6-24 months

  • Muscle weakness in children and the elderly (vitamin D only)

Given the crucial role of both nutrients in bone health, The Endocrine Society and the Institute of Medicine recommend certain consumption levels based on age and health. They have not yet found, however, that taking vitamin D provides cardiovascular protection.

 

How Does Vitamin D Affect Women’s Health

 

How Much Vitamin D and Calcium Do You Need?

The Endocrine Society and The Institute of Medicine have suggested recommended daily allowances (RDA) for vitamin D and calcium, as well as maximum daily consumption amounts that you should not exceed for your safety:

 

Population

Calcium RDA (mg)

Calcium Max (mg)

Vitamin D RDA (IU)

Vitamin D Max (IU)

0-6 months

200

1,000

400

1,000

6-12 months

260

1,500

400

1,500

1-3 years

700

2,500

600

2,500

4-8 years

1,000

2,500

600

3,000

9-13 years

1,300

3,000

600

4,000

14-18 years

1,300

3,000

600

4,000

19-30 years

1,000

2,500

600

4,000

31-50 years

1,000

2,500

600

4,000

51-70 years male

1,000

2,000

600

4,000

51-70 years female

1,200

2,000

600

4,000

70+ years

1,200

2,000

800

4,000

14-18 pregnant/lactating

1,300

3,000

600

4,000

19-50 pregnant/lactating

1,000

2,500

600

4,000



The recommendations come with two precautions:

  • Some people may need more than the RDA (after talking with their doctor) if they are:

    • Obese

    • Taking anticonvulsant medications, glucocorticoids, antifungals such as ketoconazole or medications for AIDS

  • Taking too much of either nutrient appears to be harmful, with:

    • Kidney stones associated with too much calcium from supplements

    • Very high levels of vitamin D (above 10,000 IUs per day) potentially causing kidney and tissue damage

How Do You Get Vitamin D and Calcium?

Your body makes Vitamin D when your skin is exposed to sun, but several factors limit its creation:

  • Living anywhere in the country above latitude 33 degrees (the top of Louisiana)

  • Wearing sunscreen to protect against melanoma

  • Aging, which changes absorption ability

  • The amount of sun you would need to achieve normal blood vitamin D levels is probably more than is safe for your skin, so most people may need supplements to achieve a normal vitamin D level.

Either form of vitamin D (D2 or D3) benefits the body, but very few foods naturally contain the nutrient or are fortified with it. That’s why doctors recommend supplements to make up the difference. Foods containing vitamin D include:

  • Cod liver oil: 400-1,000 IU per teaspoon

  • Wild caught salmon: 600-1,000 IU per 3.5 oz

  • Farmed salmon: 100-250 IU per 3.5 oz

  • Canned salmon: 300-600 IU per 3.5 oz

  • Canned sardines: 300 IU per 3.5 oz

  • Canned mackerel: 250 IU per 3.5 oz

  • Canned tuna: 236 IU per 3.5 oz

  • Fresh shitake mushrooms: 100 IU per 3.5 oz

  • Sundried shitake mushrooms: 1,600 IU per 3.5 oz

  • Egg yolk: 20 IU per yolk

Milk, orange juice, infant formula, yogurt, margarine, butter, cheese and breakfast cereals are often fortified with vitamin D.


Calcium is found in:

  • Dairy products

  • Chinese cabbage

  • Kale

  • Broccoli

  • Fortified fruit juices, drinks, tofu and cereals

3 people found this helpful

My daughter age is 10 +she got period 2 months before but her cycle is not fixed starting month 1st April, then April 25th then may 15th so cycle is not fixed I want to know is it normal or not let me know we should go any gynecology or it is normal cycle.

BHMS
Homeopath, Secunderabad
My daughter age is 10 +she got period 2 months before but her cycle is not fixed starting month 1st April, then April...
Please go to a gynecologist so that her health can be assessed properly. The doctor may ask for some basic tests and USG abdomen and pelvis if required. Follow the instructions and revert with the feedback.
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Hi doc my friend is 31 years old. She is having 5 months baby. During pregnancy she has labia minor edema. After delivery edema reduced but now it's not like normal shape.(the skin is elongated). Can you prescribe any cream for making that skin to reduce its elongation.

MBBS (Gold Medalist, Hons), MS (Obst and Gynae- Gold Medalist), DNB (Obst and Gynae), Fellow- Reproductive Endocrinology and Infertility (ACOG, USA), FIAOG
Gynaecologist, Kolkata
Usually after pregnancy, the labial skin will not completely return to original state naturally. She may take some drugs but if it is causing much cosmetic problem, surgery may be needed.
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