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Dr. Nirmla Phadke

Gynaecologist, Mumbai

500 at clinic
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Dr. Nirmla Phadke Gynaecologist, Mumbai
500 at clinic
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I want all my patients to be informed and knowledgeable about their health care, from treatment plans and services, to insurance coverage....more
I want all my patients to be informed and knowledgeable about their health care, from treatment plans and services, to insurance coverage.
More about Dr. Nirmla Phadke
Dr. Nirmla Phadke is an experienced Gynaecologist in Andheri East, Mumbai. She is currently associated with Phadke Nursing Home in Andheri East, Mumbai. Don’t wait in a queue, book an instant appointment online with Dr. Nirmla Phadke on Lybrate.com.

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Phadke Nursing Home

8 Modern Town, Off Mahakali Caves Road,Andheri East. Landmark:-Next To Takshashila, MumbaiMumbai Get Directions
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I am 11 weeks pregnant. It is possible of abortion. And how much it is safe. I already had an miscarriage in month of February. And what are side effect of this abortion in future. Kindly guide.

MD - Obstetrtics & Gynaecology, DGO
Obstetrician, Vadodara
I am 11 weeks pregnant. It is possible of abortion. And how much it is safe. I already had an miscarriage in month of...
Hello Santa Das Repeated Abortion is not safe for your health and future child bearing .Any infection due to abortion can make you infertile for life time. I have numbers of Patients regretting their past action. Thanks
2 people found this helpful
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Unconsummated Marriages - A Leading Cause Of Infertility!

MS sexuality, M.Phil Clinical Psychology, PhD (behaviour modification), Certified in Treatment of Resistant Depression
Sexologist, Hyderabad
Unconsummated Marriages - A Leading Cause Of Infertility!
  • Chances are you've never heard of vaginismus (or, as it is now known, genito pelvic pain penetration disorder) before. Why? Because it's the disorder nobody wants to talk about, least of all those whom it most affects - women. Vaginismus is musculature of the outer third of the vagina, which interferes with coitus and causes distress and interpersonal difficulty.
  • Among the male factor infertility, erectile dysfunction was found to be the top ranking cause accounting for 79.37% followed by premature ejaculation 12.01%, Lack of sexual desire 3.92%, homosexual orientation 2.79%, sexual aversion disorder 1.31% and disorders of sexual preference 0.61%. 
  • Vaginismus is believed to be a psycho-physiologic disorder due to fear from actual or imagined negative experiences with penetration and/or organic pathology. Women with vaginismus have also been noted to have a lack of sex education.  Vaginismus was the 63.9% , ed 11.9% , PME 8.3% , low male sexual desire 2.7%, low sexual desire in female 13.9% dysfunctional underlying non consummation of marriage is largely treatable. Adaptation to the situation usually occurs and associated factors add to the primary cause. Treatment of the underlying dysfunction can challenge the relationship.
  • Sexual dysfunction is a common problem which leads to inter-personal problems and marital discord. defined as recurrent or persistent involuntary spasm of the with coitus and causes distress and interpersonal difficulty. 

 Treating vaginismus merits a two-front approach which includes behavioral sex therapy techniques and relational intervention. When appropriate, the behavioral intervention consists of prescribing dilators (from smallest to largest) that the wife is to use in the privacy of her own home to gradually desensitize herself to penetration (the fourth and usually largest dilator is roughly the size of a penis).  While the husband may be called upon to help his wife insert the dilators (depending on his wife's comfort level), for the most part his job is to ease off the pressure for her to perform, be supportive, and try to understand his role in the marital dynamic (usually an enabling one) and the associated symptom.
Ascribing to a psychodynamic model of treatment, is helpful for a couple to understand where their symptom came from, but I'll admit this is not always necessary for them to achieve a positive outcome. Nevertheless, employing the psychodynamic systems approach to uncover any conflicts that might be behind or exacerbating the vaginismus. These underlying causes may include prior sexual abuse, chronic control struggles experienced in the family of origin, negative messages or beliefs about sex emanating from the family of origin, religious values that conflict with sexual pleasure, to name a few. I also pay close attention to the couple's interactional style in order to assess whether it, too, is a contributing factor.

 What causes it?

 

  • "Both [primary and secondary conditions] are psychologically based. "It's a physical condition, but it's a psychological condition as well.
  • "To treat it correctly, you need to treat both the physical and psychological aspects."
  • while there are many hypotheses on possible causes, its actual etiology is unknown, probably in part due to the fact sufferers are so reluctant to come forward.
  • "It's a really complex thing, And while it is influenced by many things -- there are lots of hypotheses -- the big link, for primary vaginismus anyway, seems to be strong correlation between being raised in a religious environment.
  • "This may be due to several factors including lack of information, insufficient premarital education, a cultural context strongly proscribing sexual behavior, and the expectation that intercourse take place immediately after the wedding, necessitating a radical shift from sexual abstinence to sexual intercourse.
  • Often the anxiety resulting from repeated attempts at intercourse contributes to the sexual dysfunction. One or both partners may be anxious that penetration will be painful, that there will be bleeding, or that the woman will get pregnant.  While a certain amount of anxiety surrounding sexual activity is normal, when one or both partners are overly anxious, sexual function can be affected in the following ways: The male partner may have difficulty maintaining an erection strong enough to allow penetration or he may lose his erection just prior to intercourse. Anxiety may contribute to premature ejaculation, also just prior to reaching penetration. Anxiety may prevent the woman from relaxing enough to allow penetration. She may close her legs or contract her vaginal muscles. This presentation is referred to as vaginismus, defined as the persistent or recurrent difficulty of a woman to allow vaginal entry of a penis, a finger, and/or any object, despite her expressed wish to do so. While anxiety may indeed be a factor contributing to and perpetuating many sexual problems, there are many components to sexual problems, including physiological ones. Therefore, each partner in a couple presenting with an unconsummated marriage should undergo a physical exam. 
  • Physical presentations of the female partner that might prevent intercourse can include sexual pain disorders such as localized vulvodynia, also known as vulvar vestibulitis syndrome. This fairly common condition is characterized by pain with touch at the entry to the vagina, which can prevent intercourse. A woman's hymen may be a barrier to intercourse. Some women have a very thick hymen, or a septate hymen, which is a thin piece of membrane running vertically which separates the vagina in to two sides. While most of these conditions can be addressed with sexual counseling and  physical therapy, including use of vaginal dilators, in most cases a septate hymen needs to be repaired surgically.
  •  Frequently, lack of knowledge about sexual anatomy and physiology may contribute to a situation whereby attempting intercourse feels awkward and un-natural. Often all that  is needed is some basic anatomical information  and positioning advice. For example, a couple may report that the woman's vagina feels dry and excess friction prevents intercourse. In this case, the couple may  be  advised to ensure that intercourse take place when the woman is sufficiently aroused after plenty of exciting foreplay. Over the counter lubricants may be very helpful.  While some people are physically active, very aware of their bodies, and comfortable with movement, other people are less so and may simply have not figured out how their bodies move in order to comfortably find a position for intercourse. One or both of the partners may have mobility problems or difficulty getting in to or maintaining a position. A woman may have difficulty keeping her legs open or a man may not be able to hold his weight up on his arms.  In these cases as well, consultation with a physical therapist may be helpful in providing exercises and positioning advice.
  • While behavioral solutions may be found for many couples, it is important to note that couples in unconsummated relationships, particularly of long standing duration, may benefit from couples therapy directed by a competent Sexologist. A doctor working with such a couple may wish to gain understanding in how the couple presents and organizes around the problem: How is the presenting problem perceived by each partner? Is there attribution of blame?  What is the significance of the dysfunction itself and how is that perceived by the couple? Who is aware of this situation and in what way is outside intervention (community, parents, and religious leader) perceived in assisting or perpetuating this condition?  Identifying the various factors contributing to the condition and dealing with them with physical, psychosexual, and couples therapy, may be the key to consummation and the commencement of a satisfying intimate life.
    "So we are talking about people who are raised in conservative faith, who may not have looked at their anatomy in the mirror," Small continued. "They haven't touched themselves, they haven't looked at themselves -- they may view the entire thing as being dirty."
    "In terms of the secondary form, this is a result of some kind of trauma or sexual issue, and can be triggered by something later on.
    "Women don't talk about it. They learn to live with it. I've seen cases where women have been married or in relationship for up to 12 years and only present when they want to have children."
  • Women don't talk about it. They learn to live with it. I've seen cases where women have been married or in relationship for up to 12 years and only present when they want to have children.

How to treat it

  • Most women who experience vaginismus choose to live with it rather than come forward and have it treated. Even those in long-term relationships may try to conceal what is happening from their partner or forgo sexual relations all together.
  • "If they don't do that, they cut that part of intimacy out of their relationship altogether and choose to shut down any intimate feelings they might have. They end up having a very different kind of relationship.
  • "What is important to say is there is a cure and they can be helped. That's the message that needs to get out there. Treatment for vaginismus have included systematic desensitization along with insertion of graded dilators/fingers11, drugs like anxiolytics, botulinum toxin injection,12 
  • and sex therapy. An In the Indian scenario where the talk about sex is taboo and limited among partners it becomes very essential to first improve their communication so as to improve the sex related issues. eclectic approach involving education, graded insertion of fingers, Kegel's exercises and usage of anaesthesia with vaginal containment was tried.
  • As Small previously mentioned, the best approach in terms of a cure is to seek both psychological and physical treatment.
  • For the psychological side of things, she recommends seeking out a competent female sexologist.
  • Physically, many women are taught how to use vaginal dilators in conjunction with relaxation techniques.
  • "With vaginal dilators, basically how they work is you start off very very small, and then, using relaxation techniques, slowly work your way up in terms of size.
  • "It's imperative these women have a gentle introduction and remember they are in control of the situation.
  • "There is also something called saturation therapy which is often undertaken with their partner. Using dilators, they are able to discuss their mental state and what their thoughts are at any stage. There has actually been incredible results with that. Something like 90 percent of participants report sexual success afterward." there has been some preliminary research done into the effectiveness of Botox, but states at this stage, the research is still too new to offer any kind of conclusive evidence.

Steps to take

  • If you think you or your partner might have vaginismus, it's extremely important to understand treatment is available, and, better yet, comes with a high level of success rates.
  • "The first step is to see a competent female sexologist. "It is one of those things that, when it presents, it is pretty obvious it is on a psychological basis.
  • "A sexologist may double-check everything is okay, but typically what they will find is anatomically they are fine and everything is in order and working -- the cause stems from a psychological basis.
  • "The big thing about it is it's treatable, and it is possible to lead a really fulfilled life.
3 people found this helpful

Hello Dr. I had sex with a prostate in October 2015 (condom uses) condom did not break she has a open sore blood in her vagina and she touched the sore in her finger before the sex and during the sex her nail stretch in my chest by same hand how much chance I have getting HIV.

BHMS, PGD PPHC, BMCP, TRAINING IN USG
Homeopath, Kolkata
Hello Dr. I had sex with a prostate in October 2015 (condom uses) condom did not break she has a open sore blood in h...
The chance is less but for safer side get HIv test done it is simple. Do not panic, if ant problem please consult me thanks.
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Hello doctor I am 29 years unmarried Girl m suffering from PCOS from last 4-5 years. Current size of my ovaries are Right = 19.3 n left = 16.2. (highest was l=38 n R=36) I am under Ayurveda treatment. Kindly suggest me and what is the right size of ovaries?

M.B.S.(HOMEO), MD - Homeopathy
Homeopath, Visakhapatnam
Hello doctor I am 29 years unmarried Girl m suffering from PCOS from last 4-5 years. Current size of my ovaries are R...
PCOD It is also referred to as Poly Cystic Ovarian Disease or PCOD. Another name for the disorder is Stein-Leventhal syndrome. This name comes from the two American gynaecologists Irvin F Stein and Michael L Leventhal, who first described this condition way back in 1935. PCOS means a particular set of symptoms that occur when there is a hormonal imbalance in a woman. This set of symptoms include late or no periods, heavy bleeding during periods, growth of facial hair, acne, weight gain, pain in the pelvic region and difficulty in conception or getting pregnant. When it comes to alternative systems or complementary treatments for PCOS, Homeopathy offers the best alternative. This is because Homeopathy focuses on treating and curing the root cause of the problem. The Homeopathic philosophy of disease is not based on the external causes of diseases. Homeopathy believes that the human body has been perfectly enabled by nature to keep itself disease free. It is only when the immunity or its own internal vitality is deranged that the body becomes incapable of keeping itself disease free. Therefore Homeopathy tries to restore the balance of that vitality. Once the vitality regains its original balance, it is able to nurse itself back to health without any external aid. That is why homeopathic medicines are given in very minute doses.
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Tulsi Drops

BAMS
Ayurveda, Zirakpur
Tulsi Drops

Tulsi drops

Tulsi, an incredible herb having highly beneficial medicinal properties. A powerful immuno booster, wonderful herb for respiratory system. Taking 2-4 drops of tulsi early morning works wonder on your immune system. You will never suffer from cold corrhyza, bloating problems. Tulsi has antibiotic properties, anti-inflammatory as well as anti cancerous properties.

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My girlfriend was late for her periods last 1 week we had unprotected sex and also we tested home pregnancy test the result was negative what was the problem with her.

MD - Obstetrtics & Gynaecology, MBBS
Gynaecologist, Gurgaon
Hi lybrate-user. Sometimes hormonal disturbances also cause delay in periods. Do not worry. Wait for another week for periods to start and if they still do not start then do a pregnancy test and check again.
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She is pregnant now just completed 2 months which food is better to eat for growing baby & baby when get heartbeat. Please suggest Thanks,

MD - Obstetrtics & Gynaecology
Gynaecologist, Mumbai
She is pregnant now just completed 2 months which food is better to eat for growing baby & baby when get heartbeat.

...
Heart beats are present on u. S. G. Eat fruits vegetables nuts green leafy vegetables sprouts water.
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Polycystic ovary pelvis k report me aaya hai. Kya ye cysts khatam ho sakte hain. Ha to kaise. Dawa ka naam. Ovral l 21. Pentan d.fynal oz or m2 tone.

MBBS , DGO , FIMAS
Gynaecologist, Delhi
Polycystic ovary pelvis k report me aaya hai. Kya ye cysts khatam ho sakte hain. Ha to kaise. Dawa ka naam. Ovral l 2...
This is a lifestyle disorder leading to hormonal imbalance, irregular periods, wt gain. Exercise low carbohydrate diet ,plenty of fruit and vegetables can reverse the disorder. For medication complete physical check up and investigation required .it's different for different pt depending upon age marital status symptoms and pts expectations.
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Me and my girlfriend had an intercourse last to last night and I released my semen inside her's, but she's on her periods, that was the 2nd day of her periods, so I wanna know is there any need of birth contraceptive or not, ps she has taken birth contraceptive pills many times in the past ,so I also want to take care that birth contraceptive doesn't her. Pregnancy in the future.

MD - Obstetrtics & Gynaecology, FCPS, DGO, Diploma of the Faculty of Family Planning (DFFP)
Gynaecologist, Mumbai
Me and my girlfriend had an intercourse last to last night and I released my semen inside her's, but she's on her per...
She does not need anything as intercourse was on 2nd day of period. For future learn about family planning methods and use one.
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Every month I will get periods before 5 days of that date. But this time My periods was late. My date was completed previous day. May I know what's the problem. How I get periods regularly. Can you play suggest me tablet for regular periods without side effect.

MBBS, MD - Obstetrtics & Gynaecology, FMAS, DMAS
Gynaecologist, Noida
Every month I will get periods before 5 days of that date. But this time My periods was late. My date was completed p...
Hello, Often the periods may be delayed by a few days due to stress induced hormonal imbalances, so this pattern continues for at least 3 months, then you should get investigated.
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Hello doctor I had sex yesterday night we did unprotected sex but when his about to come he take it out his penis from vagina. Is there any chance of pregnancy?

General Physician, Hyderabad
Even a single drop of semen may have thousands of sperms in it. If you are not in your safe period of cycle then there are chances that you may get pregnant. It is always safe to use protection while having sex. It not only prevents pregnancy but also protects you from sexually transmitted conditions. There are pills that can be taken within 72 hours of unprotected sex to prevent pregnancy .please contact for prescription .Take care.
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Dear doctor, What foods are best for pregnancy? Specially in first trimester? Likewise what foods shd be avoided so as to avoid gases. Kindly guide.

MBBS
General Physician, Chandigarh
Dear doctor,
What foods are best for pregnancy? Specially in first trimester? Likewise what foods shd be avoided so a...
Simple healthy and nutrious food is required all throughout the pregnancy you should not eat fried spicy and junk food eat more fresh vegetables fruits Milland nuts etc
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My wife is not pregnant even if I leave sperm inside. What can be the reason kindly let me know.

DNB (Obstetrics and Gynecology), PGDHHM, MBBS
Gynaecologist, Delhi
My wife is not pregnant even if I leave sperm inside. What can be the reason kindly let me know.
there may be any reason for infertility.first get an ultrasound of lower abdomen and thyroid profile test done and your sperm analysis test done.visit to doctor for proper medicinal treatment. you can try during ovulation period that is 8th to 18th day of menses which is fertile period when more chance for get pregnancy
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I need a proper diet chart for polycystic ovarian disease. I am gaining weight rapidly even after regular exercising & diet control.

M.Sc. in Dietetics and Food Service Management , Post Graduate Diploma In Computer Application, P.G.Diploma in Clinical Nutrition & Dietetics , B.Sc.Clinical Nutrition & Dietetics
Dietitian/Nutritionist, Mumbai
I need a proper diet chart for polycystic ovarian disease. I am gaining weight rapidly even after regular exercising ...
You need to take high fiber low fat diet. Drink lot of water everyday. Take small and frequent meals at regular intervals of 2-3 hrs. Avoid outside food completely. Ask me privately for customized diet plan for you.
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My date was 26 August. But still having no periods. I had 3 pregnancy test, all r negative. Having headache, back pain, tiredness.

MD - Alternate Medicine, Doctor of Homeopathic Medicine (H.M.D.)
Homeopath, Delhi
My date was 26 August. But still having no periods. I had 3 pregnancy test, all r negative. Having headache, back pai...
Take Pulsatilla 200 1-2 drops in 1/4 cup lukewarm water for next one month in the morning. And Alteris Ferinosa Q 5-10 drops similarly at night. For further consultation you may contact me on my personal messenger.
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I had a sex on 12/08/16 and I took ipill And now there is an irregular bleeding but my period date is around 1 and I had sex again on 22/08/16 now problem is that bleeding is not stopped yet and the condoms was tear can I take ipill again or what should I do to avoid pregnancy please help me.

MBBS, MS - Obstetrics & Gynecology, Fellowship in Infertility (IVF Specialist)
Gynaecologist, Aurangabad
I had a sex on 12/08/16 and I took ipill And now there is an irregular bleeding but my period date is around 1 and I ...
Hi Jara, it will be better if you share details of your period like cycle length how it bleeds . Frequent and routine use of ipill is not recommended.
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Hello Dr. My wife is pregnant just 2 days back we comes to know from 2 days white discharge is coming from her body. Please tell me what is that is it normal or there is any problem.

DNB (Obstetrics and Gynecology), MBBS
Gynaecologist, Mumbai
Please describe the white discharge in detail. Whether there is any foul smell or itching associated?
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3years my married life I never conceive. After check all the necessary tests we knows that my husband suffering with grade 2 varicose. IUI is possible. Sperm count 3lac motility 10%

MBBS, DNB (Obstetrics and Gynecology), MD - Obstetrtics & Gynaecology
Gynaecologist, Delhi
3years my married life I never conceive. After check all the necessary tests we knows that my husband suffering with ...
yes assisted reproduction by IUI will be an option provided your tubal patency and ovulation status is normal
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How to Control Hip Joint Pain?

Commonwealth Fellow Joint Replacement, DNB - Orthopedics, MS - Orthopaedics, MBBS
Orthopedist, Delhi
How to Control Hip Joint Pain?

Get a diagnosis before anything else. It is really important to know what is causing your pain. See a doctor before you start doing any exercises or taking any medication. There are many reasons your hip could be in pain, including arthritis, bursitis, or an injury you've got while playing a sport. Always ask your doctor what you should and should not be doing, given the cause of your hip pain.

  1. Ice your joints: Holding ice to your hips will reduce inflammation of your joints. You should hold an ice pack to the affected area for 15 minutes several times a day. If you find that the ice pack is uncomfortably cold, wrap it in a towel and then place it on the pained area.
  2. Heat your joints if you have arthritis in your hips: Heating your joints can soothe the pain you feel. Consider taking a hot bath or shower, or soak in a hot tub if there is one available to you. You could also consider purchasing a hot pad that you can place directly on your hip. Do not use heat to soothe your joints if you have bursitis. Heat can cause hips affected by bursitis to actually become more inflamed.
  3. Get some rest: If you have injured your hip, the best thing you can do is to simply give your hip time to heal. Avoid anything that causes you to feel pain in your hip. Instead, grab an ice pack, a bowl of popcorn and watch some movies. You should give your hip a rest for at least 24 to 48 hours.
  4. Avoid high-impact activities: If you are in severe pain, chances are you won't feel like running or jumping anyway, but it is good to keep in mind that these activities should be avoided. High-impact activities will cause your joints to become more inflamed, thus causing your more pain. Instead of running, try taking a brisk walk, as walking has much less of an impact on your joints.
  5. Consider losing weight: The more your body weighs, the more weight your painful hip is burdened with supporting. Losing weight can help ease hip pain simply by removing some of that weight that stresses the cartilage and joints.
  6. Choose the right shoes: You should buy shoes that give you as much support as possible. Look for shoes that have great cushions, or have removable insoles so that you can add orthopaedics. The sole should have good shock absorption, should limit pronation (turning or rotating the foot) and will evenly distribute pressure along the length of your foot.
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