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Endometrial Ablation Procedure
Treatment of Treatment of Breast Cancer
Management of Abortion
Hormonal Replacement Therapy Treatment
Caesarean Section Procedure
Treatment of Gynae Problems
Gynecology Laparoscopy Procedures
Treatment Of Female Sexual Problems
Treatment Of Menopause Related Issues
Treatment Of Menstrual Problems
Treatment of Mirena (Hormonal Iud)
Pap Smear Procedure
Polycystic Ovary Syndrome Treatment
Treatment of Uterine Bleeding
Antenatal And Postnatal Exercise
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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:
- Milky nipple discharge (galactorrhoea)
- Hair loss
- Vision changes
- Excess facial hair (Hirsuitism)
- Pelvic pain
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.
During the normal course of your life, you may experience amenorrhea for natural reasons, such as:
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.
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:
- 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.
- 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.
- 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.
Many types of medical problems can cause hormonal imbalance, including:
- Polycystic ovary syndrome (PCOS): PCOS causes relatively high and sustained levels of hormones, rather than the fluctuating levels seen in the normal menstrual cycle.
- Thyroid malfunction: An overactive thyroid gland (hyperthyroidism) or underactive thyroid gland (hypothyroidism) can cause menstrual irregularities, including amenorrhea.
- Pituitary tumor: A noncancerous (benign) tumor in your pituitary gland can interfere with the hormonal regulation of menstruation.
- Premature menopause: Menopause usually begins around age 50. But, for some women, the ovarian supply of eggs diminishes before age 40, and menstruation stops.
Problems with the sexual organs themselves also can cause amenorrhea. Examples include:
- 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.
- 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.
- 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.
A variety of blood tests may be necessary, including:
- Pregnancy test: This will probably be the first test your doctor suggests, to rule out or confirm a possible pregnancy.
- Thyroid function test: Measuring the amount of thyroid-stimulating hormone (TSH) in your blood can determine if your thyroid is working properly.
- 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.
- Prolactin test: Low levels of the hormone prolactin may be a sign of a pituitary gland tumor.
- 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.
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:
- 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.
- 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.
- 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.
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.
I had withdrawal sex on 14th day of my cycle or 9th day after my periods ended. Should I take an ipill to avoid getting pregnant or it's not necessary. please suggest the useful.
The diagnosis of menopause is made after periods have stopped for at least 1 year after the age of 40 due to reducing ovarian activity.The age span can vary between 45 to 55 and the median age is 52 years.Menopause occurring before the age of 40 is premature and one needs to consult a Gynaecologist.
The time span for several months to several years leading to menopause is called perimenopause.The periods during this time may become irregular and the patient may experience hot flushes, night sweats, anxiety, mood swings etc; 30-60% of women may experience emotional symptoms at this time. The major symptoms include:
- Hot Flushes and Night seats
- Vaginal dryness
- Tiredness and sleep disturbances
- Mood swings and lack of concentration
- Loss of interest in having sex
Every woman experiences menopause differently. A few will have a combination of different mild symptoms while others will have more severe symptoms.Some women choose to go through menopause without any treatment whereas others prefer to have hormonal or non-hormonal medications to help control their symptoms.
However it is important to consult a Gynaecologist as irregular periods and other symptoms may be due to other pathologies and may need investigating.
A healthy lifestyle is very important during this time to maintain good bone health and general health.Regular aerobic exercises like swimming, jogging, brisk walking and in general maintaining an active lifestyle and maintaining an optimal body mass index is very important and helps in preventing osteoporosis, heart disease etc;
- Low-intensity exercises such as yoga may help to reduce hot flushes and boost general well-being.
- Reducing intake of tea/coffee/ caffeinated drinks will help reduce hot flushes and night sweats.
- Vaginal lubricants and moisturisers help in reducing vaginal dryness during intercourse.
- Also equally important is having a diet rich in Calcium, proteins and low in fat and refined carbohydrates like sweets and junk foods.
- Soya-based foods like soya beans, chickpeas, peas are rich is phytoestrogens nad may help in reducing perimenopausal/ menopausal symptoms.
- Getting an annual health check up done helps in identifying risks earlier and taking appropriate actions earlier on.
- Women should have regular PAP smears, BP check, Mammograms, Lipid profile done and other tests if clinically indicated.
Finally, it is best to consult a Gynaecologist if a woman is having any perimenopausal or menopausal symptoms so that appropriate treatment can be instituted.
I have pcod and trying to conceive. My doctor gave me three month course of clofert 50 mg. First month it didn't work. Second month it worked and matured egg but pregnancy not happen. Third month again it didn't work till 18th day of period and after 18th day I didn't continue monitoring because I was demoralised. Now I am waiting for my periods and its not coming, my last month date is 7th June. I did pregnancy test at home it was negative. From last 4-5 days brown discharge is also coming but periods are not coming. Can you tell me what it happens. Is there any kind of expectation or its just periods delay because of irregularity. Trying to conceive from last two years.
My periods are late I check on I can preg test but it's negative . I am having very little bleeding some times . Am I pregnant ? I don't want to be right now ? What are the measures or pills I can take for my mensuration ? And not getting pregnant ?
My wife is 7 weeks pregnant. We had taken obstetrics scan and antenatal tests. The doctor said everything is normal. Yesterday night she had back pain and vaginal itching. Is it normal? We are worried about the itching. Did she got any infection that affect the baby?
My period is 3 days late and I have some symptoms clear watery discharge, frequent urination, leg pain, breast tenderness is it symptoms of pregnancy?
Hello doctor I am medico student I often hear doc saying it is ideal to plan for a child after 1 years of married life why is it so I want to knew the reason behind this statement.
I am having irregular periods since long time ,and also having back pain alot. Is my bk pain a reason of irregularity of periods. How cn this be cured. My age is 27.
M 22. My periods are normal n perfect. I ended my last period on 25th and ysterdy I noticed that I have blue spots on my panties. I dnt have any pain nothing. What it could be m so worried please help me. Its dry and only on centre of pantry. please HELP ME.
Sir, sex karne ke safe day's kis date ko hote h because female pregnant na ho but female ke period ke safe days kaunsa se hote h ?
One of the most common scenarios that most people are faced with is a constant feeling of tiredness and lethargy even after you have had a full night’s sleep. The questions popping in your mind right about now is, why is this happening? Why does the lethargic feeling fail to leave you even after you had a proper 8 hours sleep? Why is your sleep getting into the way of your professional productivity? Though there are a number of different explanations to this constant feeling of cloudiness throughout the day, hence, experts in the field have listed down some of the factors that prove to be the major causes behind this condition.
Some of these most common and powerful reasons are listed below.
- Thyroid: The moment your thyroid levels start soaring, you will automatically find it difficult to keep up with the pace that your day to day life demands. The thyroid gland, which is placed right in front of the throat, is the size of the knot on your tie. This gland produces a hormone. When the activity of the thyroid gland, it starts secreting more and more of the hormones, leading to a condition termed as hyperthyroidism. The same gland when underperforms, it starts holding back the hormone secretion, leading to a condition called hypothyroidism. In both the cases the metabolism of the body slows down, leading to an increased level of tiredness even after proper sleep.
- Anaemia: Another leading cause of that nagging feeling of sleepiness and draining energy is Anaemia. Anaemia causes a certain amount of fatigue in an individual. The main cause influencing this situation is the lack of presence of enough red blood cells. The main function of these red blood cells is to transfer oxygen constantly from the long to the cells and tissues. A break in this process leads to you feeling weak and also short of breath.
- Diabetes: Diabetes poses a serious threat to the all over functioning of your body. It is termed as the slow killer and constantly works towards undermining the level of energy a normal individual can hold. This adversely affects your day to day life, including your performance at work and also performing your daily chores at home. The glucose in your body serves as a fuel for your daily activities. Since patients with type 2 diabetes cannot use this rising glucose in their blood properly, they end up being more tired than they ought to be.
Other conditions that lead to the same draining feeling and constant tiredness even after lot of sleep are depression, rheumatoid arthritis, chronic fatigue, sleep apnea, sleep inertia, periodic limb movement disorder, constant exposure to computer screens, tv screen, monitors, etc. There are a whole bag of other factors that lead to the constant feeling of tiredness that you are feeling. Before the end of the day, you are drained, your productivity drops and you cannot wait to hit the bed, and the same is the condition when you get out of bed. Consulting a general physician will not only help you put a finger on the cause, but also cure it with proper treatment.
• Cut down salt (common table salt) intake in your diet to avoid hypertension. Intake should not exceed more then 2 to 2.5 gm a day.
• Avoid foods rich in cholesterol: ground nut oil, ghee, butter, whole milk, eggs, lard (fats derived from pig meat), tallow (fats derived from goat or sheep mutton) – all non-vegetarian food contain cholesterol in varied amount.
• Avoid non-vegetarian food especially red meat.
• Increase intake of foods that contain PUFA`s (poly unsaturated fatty acids): flax / linseed oil is the richest source of PUFA`s. Other oils that contain PUFA`s are safflower oil, soybean oil, sesame oil, olive oil. As all oils are high in fats, its consumption should be limited. The intake of oils should not exceed 20gms a day.
• Sesame oil and almond oil hinders the absorption of LDL (low-density lipoproteins), so it is advisable to use replace other cooking oils by sesame oil.
• Increase your intake of water.
• Consume whole grain cereals and whole pulses.
• Take high fiber diet - whole grains, bran, oat, green leafy vegetables etc.
• Cut down the intake of sugar and other sweeteners.
• Avoid fat-rich portions of flesh foods. Instead have lean meat.
• Avoid fat-rich desserts and fried snacks like cakes, pastries, puddings etc
• Instead of frying food boil, steam, grill or roast food.
• Avoid coffee and caffeinated drinks, junk food – pizza, burgers etc.
• Consume food rich in magnesium.
– Nuts and sea food, green leafy vegetables, sea plants like Japanese sea plants, whole grains, peas, lotus stem, pulses, legumes and oil seeds.
• Increase intake of vitamin C, it maintains the elasticity and integrity of the artery walls.
– Citrus fruits, green leafy vegetables, vegetables- cabbage, broccoli, tubers- potatoes and sweet potatoes.
• Increase calcium intake:-
– milk and sea food, nuts- ground nuts, walnut, almond and cashew nuts; green leafy vegetables, whole grains, fruits like - custard apple and banana.
– Peas, lotus stem, pulses, legumes and oil seeds
I had aborted in June 2016. Now, I am pregnant 8 weeks. My below blood test are out of normal range. Antiphospholipid antibody IGG- 38.18 GPL U/ml IGM- 16.66 MPL U/ml Anti cardiolipin IGG - 41.13 GPL U/ml IGM - 18.01 MPL U/ml And following two test are in normal range. ProthrombinTime -12 second International Normalized Ratio- 1 My question is that: is I need blood thinning treatment (ecosprin/heparin) as per above test result? I am in confusion because Dr. Prescribed to me:- - Ecosprin 75 mg (daily) - Clexane injection, low molecular weight heparin (40 mg, daily), Both for 8 months.
Infertility is characterized by the inability to get pregnant even after unprotected intercourse for over a year. Repeated miscarriages along with other factor can often be the reason behind infertility in women.
Probable causes of Infertility in Women:
The most common cause of infertility in women is an abnormal uterus. Congenital flaws, such as septate uterus can lead to repeated miscarriages. The normal pH level of the uterus is approximately in the range of 6.6 to 7.6. So a pH level below or above this range can lead to an abnormal uterus.
Ovulation defects (such as the eggs not properly maturing in the ovaries or the ovaries not releasing mature eggs) are other causes as well.
Another possible cause is Endometriosis, a condition wherein the tissues which line the inner walls of the uterus start to grow on the outsides of the uterus, such as in the pelvis or the abdomen.
Polycystic Ovarian Syndrome (PCOS), a condition wherein the ovaries become enlarged with tiny cysts growing on them, is another important cause for infertility. Hormonal imbalances are at the root of this condition.
A block or damage to the fallopian tubes can prevent the sperm to properly fertilize the egg thus, leading to infertility.
Unhealthy lifestyle habits such as obesity or being underweight, excessive alcohol consumption, smoking and not following a healthy diet are other important causes of infertility. If you wish to discuss about any specific problem, you can consult a gynaecologist.