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Dr. Nitin Divate

Gynaecologist, Mumbai

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Dr. Nitin Divate Gynaecologist, Mumbai
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I'm dedicated to providing optimal health care in a relaxed environment where I treat every patients as if they were my own family....more
I'm dedicated to providing optimal health care in a relaxed environment where I treat every patients as if they were my own family.
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Dr. Nitin Divate is a trusted Gynaecologist in Borivali West, Mumbai. You can meet Dr. Nitin Divate personally at Phoenix Hospital in Borivali West, Mumbai. Book an appointment online with Dr. Nitin Divate and consult privately on Lybrate.com.

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Phoenix Hospital

Padma Nagar,Chikuwadi-Borivali West,Landmark: Near Vrindavan Tower, MumbaiMumbai Get Directions
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Amenorrhoea - Causes Behind Primary and Secondary Type

FRCOG (LONDON) (Fellow of Royal College of Obstetricians and Gynaecologists), CCT (Lon), DNB (Obstetrics and Gynecology), MD
Gynaecologist, Mumbai
Amenorrhoea - Causes Behind Primary and Secondary Type

Amenorrhea is the absence of menstruation that is one or more missed menstrual periods. Women who have missed at least three menstrual periods in a row have amenorrhea, as do girls who haven't begun menstruation by age 16. The most common cause of amenorrhea is pregnancy. Other causes of amenorrhea include problems with the reproductive organs or with the glands that help regulate hormone levels.

Treatment of the underlying condition often resolves amenorrhea.The main sign of amenorrhea is the absence of menstrual periods. Depending on the cause of amenorrhea, you might experience other signs or symptoms along with the absence of periods, such as:

  1. Milky nipple discharge (galactorrhoea)
  2. Hair loss
  3. Headache
  4. Vision changes
  5. Excess facial hair (Hirsuitism)
  6. Pelvic pain
  7. Acne

You should consult a doctor if you've missed at least three menstrual periods in a row, or if you've never had a menstrual period and you're age 16 or older.

Causes: Amenorrhea can occur for a variety of reasons. Some are normal during the course of a woman's life, while others may be a side effect of medication or a sign of a medical problem.

Natural amenorrhea
During the normal course of your life, you may experience amenorrhea for natural reasons, such as:

Contraceptives
Some women who take birth control pills may not have periods. Even after stopping oral contraceptives, it may take some time before regular ovulation and menstruation return. Contraceptives that are injected or implanted also may cause amenorrhea, as can some types of intrauterine devices.

Medications
Certain medications can cause menstrual periods to stop, including some types of:

  • Psychiatric medications
  • Cancer chemotherapy
  • Blood pressure drugs
  • Allergy medications
  • Lifestyle factors

Sometimes lifestyle factors contribute to amenorrhea, for instance:

  1. Low body weight: Excessively low body weight, about 10 percent under normal weight interrupts many hormonal functions in your body, potentially halting ovulation. Women who have an eating disorder, such as anorexia or bulimia, often stop having periods because of these abnormal hormonal changes.
  2. Excessive exercise: Women who participate in activities that require rigorous training, such as gymnastics,athletics may find their menstrual cycles interrupted. Several factors combine to contribute to the loss of periods in athletes, including low body fat, stress and high energy expenditure.
  3. Stress: Mental stress can temporarily alter the functioning of your hypothalamus an area of your brain that controls the hormones that regulate your menstrual cycle. Ovulation and menstruation may stop as a result. Regular menstrual periods usually resume after your stress decreases.

Hormonal imbalance
Many types of medical problems can cause hormonal imbalance, including:

  1. Polycystic ovary syndrome (PCOS): PCOS causes relatively high and sustained levels of hormones, rather than the fluctuating levels seen in the normal menstrual cycle.
  2. Thyroid malfunction: An overactive thyroid gland (hyperthyroidism) or underactive thyroid gland (hypothyroidism) can cause menstrual irregularities, including amenorrhea.
  3. Pituitary tumor: A noncancerous (benign) tumor in your pituitary gland can interfere with the hormonal regulation of menstruation.
  4. Premature menopause: Menopause usually begins around age 50. But, for some women, the ovarian supply of eggs diminishes before age 40, and menstruation stops.

Structural problems
Problems with the sexual organs themselves also can cause amenorrhea. Examples include:

  1. Uterine scarring: Asherman's syndrome, a condition in which scar tissue builds up in the lining of the uterus, can sometimes occur after a dilation and curettage (D&C), cesarean section or treatment for uterine fibroids. Uterine scarring prevents the normal buildup and shedding of the uterine lining.
  2. Lack of reproductive organs: Sometimes problems arise during fetal development that lead to a girl being born without some major part of her reproductive system, such as her uterus, cervix or vagina. Because her reproductive system didn't develop normally, she can't have menstrual cycles.
  3. Structural abnormality of the vagina: An obstruction of the vagina may prevent visible menstrual bleeding. A membrane or wall may be present in the vagina that blocks the outflow of blood from the uterus and cervix.

Clinical examination by the doctor  includes a pelvic exam to check for any problems with your reproductive organs. If you've never had a period, the doctor may examine  your breasts and genitals to see if you're experiencing the normal changes of puberty.

Amenorrhea can be a sign of a complex set of hormonal problems. Finding the underlying cause can take time and may require more than one kind of test/investigation.

Lab tests
A variety of blood tests may be necessary, including:

  1. Pregnancy test: This will probably be the first test your doctor suggests, to rule out or confirm a possible pregnancy.
  2. Thyroid function test: Measuring the amount of thyroid-stimulating hormone (TSH) in your blood can determine if your thyroid is working properly.
  3. Ovary function test: Measuring the amount of follicle-stimulating hormone (FSH) or AMH (anti-mullerian hormone) in your blood can determine if your ovaries are working properly.
  4. Prolactin test: Low levels of the hormone prolactin may be a sign of a pituitary gland tumor.
  5. Male hormone test: If you're experiencing increased facial hair and a lowered voice, the doctor may want to check the level of male hormones in your blood.

Hormone challenge test
For this test, you take a hormonal medication for seven to 10 days to trigger menstrual bleeding. Results from this test can tell the doctor whether your periods have stopped due to a lack of estrogen.

Imaging tests
Depending on your signs and symptoms — and the result of any blood tests you've had, the doctor might recommend one or more imaging tests, including:

  1. Ultrasound: This test uses sound waves to produce images of internal organs. If you have never had a period, your doctor may suggest an ultrasound test to check for any abnormalities in your reproductive organs.
  2. Computerized tomography (CT): CT scans combine many X-ray images taken from different directions to create cross-sectional views of internal structures. A CT scan can indicate whether your uterus, ovaries and kidneys look normal.
  3. Magnetic resonance imaging (MRI): MRI uses radio waves with a strong magnetic field to produce exceptionally detailed images of soft tissues within the body. Your doctor may order an MRI to check for a pituitary tumor.

Endoscopy tests
If other testing reveals no specific cause, the doctor may recommend a hysteroscopy — a test in which a thin, lighted telescope is passed through your vagina and cervix to look at the inside of your uterus.

Treatment depends on the underlying cause of your amenorrhea. In some cases, contraceptive pills or other hormone therapies can restart your menstrual cycles. Amenorrhea caused by thyroid or pituitary disorders may be treated with medications. If a tumor or structural blockage is causing the problem, surgery may be necessary. Some lifestyle factors — such as too much exercise or too little food — can cause amenorrhea, so strive for balance in work, recreation and rest. Assess areas of stress and conflict in your life. If you can't decrease stress on your own, ask for help from family, friends or your doctor.
Be aware of changes in your menstrual cycle and check with the doctor if you have concerns. Keep a record of when your periods occur. Note the date your period starts, how long it lasts and any troublesome symptoms you experience.

2411 people found this helpful

Hi doctors, My wife was pregnant with 2 and half month, but there is no growth inside of child. There is no positive result in ultra sound. Gynacolist saying I have to go with abortion. So just want to know is there any medicine of abortion or we go with operation. Pls suggest ASAP. Thanks.

MD - Psychiatry
Psychiatrist, Chennai
Hi doctors,
My wife was pregnant with 2 and half month, but there is no growth inside of child. There is no positive ...
at two an half months means around 10 weeks, it is safe to undergo MTP (medical termination of pregnancy), under the guidance of an experienced OG cian, done in an approved centre. Medical abortion can many a times lead to serious blood loss and loss of life is a common risk, so better go for surgical intervention.
3 people found this helpful
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I am working in night shift from 5 to 2.30. Am over weight due to imbalance life style. Am unable to balance my health being in this shift can you guide me how to maintain my health. Need some healthy tips.

Bachelor of Ayurveda, Medicine and Surgery (BAMS), MD - Ayurveda
Ayurveda, Pune
I am working in night shift from 5 to 2.30. Am over weight due to imbalance life style. Am unable to balance my healt...
drink warm water all times,take sleep before taking food during day time,do simple walking for 45 minutes in a day,take healthy food,fresh fruits,salads,dry fruits, avoid oily,fatty,fast,bakery food,excessive tea,coffee,cold drinks
3 people found this helpful
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Hi, my periods came in 20th april, and again in may 13th, and again in june 13th, what are my fertility days and ovulation day, my period lasts for 5dys.

BHMS
Homeopath, Faridabad
Hi, my periods came in 20th april, and again in may 13th, and again in june 13th, what are my fertility days and ovul...
Hello, Most women ovulate anywhere between Day 11 – Day 21 of their cycle, counting from the first day of the LMP. Thanks.
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I am married from almost two months. Now my wife want to conceive. Our age is almost same 35 yrs. Kindly tell Some tips so that our dream come true.

MBBS, MD - Obstetrtics & Gynaecology, FMAS, DMAS
Gynaecologist, Noida
I am married from almost two months. Now my wife want to conceive. Our age is almost same 35 yrs. Kindly tell Some ti...
Hello, Please follow her fertile period and ovulation time to have sex to increase her chances of pregnancy.
1 person found this helpful
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My daughter, ruchi, 22 yrs, is having a problem of poly cystic ovaries, for which she has been prescribed Diane 35. Is the medicines only solution or any not solution for this.

MBBS, DNB (Obstetrics and Gynecology), MD - Obstetrtics & Gynaecology
Gynaecologist, Delhi
There are other modes of therapy as well. In resistant cases laaroscopic drilling of the cysts may be done too. Weight reduction will help a lot.
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Its been 1 month and 20 days since delivery but my wife faces the problem that she attains sudden high fever with sever pain in all bones and body and feels shivering cold. This happens almost after a week or 3-4 days. Doctors are not diagnosing any thing. Please doctors need serious help.

B.H.M.S., M.D. (Homoeopathy)
Homeopath, Surat
Its been 1 month and 20 days since delivery but my wife faces the problem that she attains sudden high fever with sev...
Hello, give her eupatorium perfoliatum 30 (homoeopathic medicine) 5 globules, twice a day for 3 days. She will be alright within 3-4 days. Let me know if you need any other help. How to take homoeopathic medicine? don't touch the globules, put it directly in to the mouth via cap of medicine bottle. Just chew the globules, don't take water with it. You should not eat or drink anything before and after 15 minutes of taking medicines.
8 people found this helpful
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I had sex with my boyfriend before 2 days. After that I am feeling tired and stomach pain is starting not so severe but there is a pain which is not continuous hate to eat. Is this says am pregnant ?

Diploma in Naturopathy & Yogic Science (DNYS)
Ayurveda, Bangalore
I had sex with my boyfriend before 2 days. After that I am feeling tired and stomach pain is starting not so severe b...
Uterus got severe punch by the penis. You should understand penis is a shooting gun. You cannot absorb pains while you doing sex. Later on it may show the side effect. Try to avoid hard intercourse and first try with matured elders to make the uterus to get good functioning. Now you should take ayurvedic medicine like satavari and ashokarista. Further medical need you should meet us thank you.
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Hi, I am 29 years old unmarried woman with height 5'6" and weight 55 KGS which is normal. I have PCOD or PCOS. I tried all medicines. I get periods only if I am under medication. I don't what junk foods or have carving for sweets. I am working currently not that hectic though. I have lot of facial hair and have hair loss. Is there any natural way to cure PCOD? My doctor's say my uterus is little small but this is not an issues. Not sure what the issue is?

MBBS, DGO, DNB (Obstetrics and Gynecology)
Gynaecologist, Delhi
Hi, I am 29 years old unmarried woman with height 5'6" and weight 55 KGS which is normal. I have PCOD or PCOS. I trie...
PCOD is a state of hypothalamic pituitary ovarian dysfunction. Besides menstural irregularities it also causes excessive weight gain, acne, facial hair growth and fertility issues. It is managed by medicine, diet and exercise.
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I am suffering with breast pain which frequently comes from one month but I have this from 13 now my age is 20. Can you give me suggestions please ?

MBBS; M.S.
Gynaecologist, Sri Ganganagar
Take b long f 1daily x 30 days. Tab primrosa 1 daily x 30 days. Cap evion 1 daily x 30 days. Give me feed back.
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Green Tea

M.Sc - Dietitics / Nutrition
Dietitian/Nutritionist, Bangalore
Green Tea
Green tea contains high amounts of polyphenols, which are antioxidants. Polyphenols are known to have anti-oxidative properties which can help prevent type 2 diabetes.

Epigallocathechin gallete (egcg) is a polyphenol, the most abundant form of catechin in green tea. It is known to be the main attributable factor of beneficial effects of green tea. Through a complex biochemical reaction, egcg in green tea helps sensitize cells so they are better able to metabolize sugar, which is beneficial for both type 1 and 2 diabetes.

Green tea consumption is associated with reduced mortality due to all causes and cardiovascular disease. It is effective in decreasing blood pressure, low density lipoprotein cholesterol, oxidative stress, and a marker of chronic inflammation. This acts as a therapeutic tool for obesity also.

Green tea is good for people with diabetes because it helps the metabolic system function better.

Question 1) whether D & C procedure required to check prolonged menstrual bleeding (Not that high but continuing from more than a month) 2) Ultrasound indicate Endometrial thickness of 10.5 mm, 3) Doctor advised D & C due to this high thickness of endometrium. 4) Patient also has PCOS problem.

Fellowship in Minimal Access Surgery, MS - Obstetrics and Gynaecology, MBBS
Gynaecologist, Bangalore
Question 1) whether D & C procedure required to check prolonged menstrual bleeding (Not that high but continuing from...
Dear Lybrate user, It is better to follow what your doctor has advised, since in online consultation, one cannot know about full details. With the inputs you have given, it seems that Medical therapy can be tried.
1 person found this helpful
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I am 22 year old girl, I have had irregular menstruation problem, it gets normal with medicine but I need a permanent home solution. Can you please suggest a home remedy.

Ph.D - Ayurveda, FFAM-Post Graduate Fellowship, MD - Ayurveda
Ayurveda, Delhi
There are many home remedies, depends on type of prakruti, your height, weight and mental attitude required for proper home remedies.
1 person found this helpful
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I am 28 year old. I got married 9 years back and started treatment 4 year back for get pregnancy. Doctor says all reports normal and went IUI process also. Still I didn't get pregnancy. What should I do.

MD - Homeopathy, BHMS
Homeopath, Vadodara
I am 28 year old. I got married 9 years back and started treatment 4 year back for get pregnancy. Doctor says all rep...
If all the reports are normal then there are certain things to look for. Do you have any stress. As I have found many couples who could not conceive just because they were very stressful and anxious regarding the pregnancy. Especially the fear what if they couldn't.So first relax and leave all the worries. Second there are chances that vaginal secretions are not providing the optimum environment to the sperm to live till they reach the ovum. And like wise. I am sure your doctor have taken these in consideration but still if you like you may take homoeoapthic medicine from a good homoeopath of your own choice.
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I am 30 years old and diagnosed hypothyrodism in 8th week pregnancy tsh value was 24.6and started thyrorite tablet 50mg. After two months I again given blood sample my tsh was 10.96. Dose of thyoxine increase to 75 mg. Is there any harm to my baby due to hypothyrodism.?

C.S.C, D.C.H, M.B.B.S
General Physician,
I am 30 years old and diagnosed hypothyrodism in 8th week pregnancy tsh value was 24.6and started thyrorite tablet 50...
No if your thyroid is controlled. Soon after birth bab's tsh has to be checked. Keep in personal touch for regular advice.
1 person found this helpful
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Dr. I want to know about menopause. My age is 44. I am facing health problem such as chest pain headache uneasyness.

DGO, MD, MRCOG, CCST, Accredation in Colposcopy
Gynaecologist, Kolkata
Dr. I want to know about menopause. My age is 44. I am facing health problem such as chest pain headache uneasyness.
Menopause is when you have not had periods for a year. Usual age is 50-52. Yrs. 45 years onwards is per-menopausal period when women may start having irregular periods or reduced flow and hot flushes and night sweats. However I still strongly advise you get a doctors opinion in person regards to you problems.
2 people found this helpful
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My friend she had done marriage before 3 year back. But she is not pregnant .she is very upset. All the reports are good .can you suggest me anything its can be helpful for her.

MD - Obstetrtics & Gynaecology, Fellowship in Infertility
IVF Specialist, Noida
My friend she had done marriage before 3 year back. But she is not pregnant .she is very upset. All the reports are g...
Hi. It is important that the couple visit a clinician for few basic tests for both the husband and wife. Meanwhile they can also try during the fertile period which is roughly around 14 th day in a 28 day menstrual cycle.
3 people found this helpful
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Hi I am pregnant I got my beta hcg done first time in 4 week it was 237 thn after 72 hours I repeated beta hcg now its 821.58 is this a normal pregnancy or any problem.

Diploma in Advanced Gynaec Laparoscopic Surgery, Fellowship in Laparoscopic and Robotic Onco-Surgery, MD - Obstetrtics & Gynaecology, MBBS
Gynaecologist, Zirakpur
Hi I am pregnant I got my beta hcg done first time in 4 week it was 237 thn after 72 hours I repeated beta hcg now it...
Hi lybrate-user My suggestion is that you should wait till you cross at least 6 weeks after your last periods. Once this period is over then you must go for scan to confirm the pregnancy status. B hcg evaluations by self are sometimes misleading as they need to be co related with your clinical parameters. Otherwise also, the confirmation of baby on imaging is most definite way of confirming pregnancy.
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I am using fujivag cl. 3 days. I am 20 week pregnant. after using this medicine when I go stool pass I have thick white discharge. It is reason for, putting medicine. Or other? It is normal?

BHMS
Homeopath, Hyderabad
I am using fujivag cl. 3 days. I am 20 week pregnant. after using this medicine when I go stool pass I have thick whi...
This is because of the fungal infection you are having this white discharge. It's not normal and this needs medication if you are on medication continue it.
1 person found this helpful
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