Dr. Veena G. Shinde

Trichomoniasis is one of the most commonly occurring sexually transmitted infections. It generally happens on account of having multiple sexual partners or not using condoms and other protective measures during sexual intercourse (vaginal or anal).

Trichomoniasis leads to a foul smelling vaginal discharge and other symptoms that include spotting/bleeding, painful urination, itching in the vaginal region, all of them resulting in painful sexual intercourse. The single- celled protozoa (pathogen) causing this infection is Trichomonas vaginalis.

Symptoms-

The most common symptoms among women are:

1. vaginal discharge, which can be white, gray, yellow, or green, and usually frothy with an unpleasant smell
2. vaginal spotting or bleeding
3. genital burning or itching
4. genital redness or swelling
5. frequent urge to urinate
6. pain during urination or sexual intercourse

The most common symptoms in men are:

1. discharge from the urethra
2. burning during urination or after ejaculation
3. an urge to urinate frequently

Treatment Options for Trichomoniasis-

The treatment options for Trichomoniasis can be categorized as follows:

1. Antibiotics such as ‘Tinidazole’ or metronidazole can be administered.

2. It is advisable not to consume alcohol within the first 24 hours of being administered ‘metronidazole’ and the first 72 hours of being administered tinidazole as it can lead to severe vomiting and nausea.

3. Metronidazole is strictly advised against during pregnancy as it can harm the baby.

How to Prevent Trichomoniasis?

The preventive measures include:

1. Indulging in safe sex is the best way to prevent Trichomoniasis.

2. Condoms should be used by both the male and the female partners during a sexual intercourse (anal or vaginal).

3. Sharing sex toys is another big ‘NO’ as the carriers of various STDs may spread through their common usage.

4. If a person has already been infected by Trichomoniasis then abstaining from sex is the safest option to prevent it from spreading.

In case you have a concern or query you can always consult an expert & get answers to your questions!

During a normal pregnancy, a fertilised egg travels through the fallopian tube to the uterus. The egg attaches itself in the uterus and begins to develop. In an ectopic pregnancy, the egg attaches outside the uterus, most often in fallopian tube. This is the reason why it is also called a tubal pregnancy. In rare cases, the egg may implant itself in an ovary or the cervix.

There is no way to prevent an ectopic pregnancy. Also, it cannot be transformed into a normal pregnancy. If the egg continues developing in the fallopian tube, it can rupture the tube; the result of this could be fatal. If you have an ectopic pregnancy, you will require immediate treatment to end it before it causes any risks.

Risks involved: Things that make you more prone to an ectopic pregnancy are:

• The more you smoke, the higher your danger of an ectopic pregnancy.
• Pelvic incendiary malady (PID). This is the after effect of contamination, for example, chlamydia or gonorrhea.
• Endometriosis, which can bring about scar tissue in or around the fallopian tubes.
• Exposure to a chemical called DES before you conceived.

Symptoms: The signs of an ectopic pregnancy are:

• Pelvic pain. It might be sharp on one side at first before spreading through your belly. It might be more painful when you move or strain
• Vaginal bleeding

Diagnosis: To see whether you have an ectopic pregnancy, your specialist will probably take:

• A pelvic exam to check the span of your uterus and feel for any kind of growth in your tummy.
• A blood test that checks the level of the pregnancy hormone (hCG). This test is repeated 2 days after the fact. In early pregnancy, the level of this hormone duplicates itself every two days. Low levels recommend an issue, for example, ectopic pregnancy.
• An ultrasound. This test can demonstrate pictures of what is inside. With ultrasound, a specialist can more often than not see a pregnancy in the uterus 6 weeks after your last menstrual period.

Treatment: The most widely recognised treatments are medicines and surgery. As a rule, a specialist will treat an ectopic pregnancy immediately to prevent harm to the lady.
Prescription can be utilised if the pregnancy is discovered right on time, before the tube is harmed. Much of the time, one or more shots of methotrexate will end the pregnancy. Taking the shot gives you a chance to keep away from surgery; however, it can bring about reactions. You should see your specialist for follow-up blood tests to ensure that the shot worked.

For a pregnancy that has gone past the initial couple of weeks, surgery is a better option than medication. In this event, the surgery will be a laparoscopy.

In case you have a concern or query you can always consult an expert & get answers to your questions!

I’m Dr. Veena Shinde. I’m obstetric, gynecologist and infertility specialist.

I have been practicing in Mumbai since last 26 years. And I’m seeing the trends that girls today don’t want to be pregnant at an early age. But they have a facility of egg freezing. And with experience today we can get good embryos once we retrieve the eggs at younger age. See many of the girls have living relationships but because of career they are not able to have a baby at a younger age. The best age is 22 to 28 even 30. I have seek girls coming at 39 for egg freezing, it is very difficult to get good quality eggs at 39 years of age. Although you are financially independent and in a state to freeze your eggs at 39, it’s not recommended that you freeze your eggs at 39. You should do this between 25 to 30 years of age.

If you need any more information you can contact me on lybrate.com

Nothing can be more gratifying than welcoming your bundle of joy into this world. Care needs to be taken during pregnancy to ensure that the developing foetus is healthy. Many pregnant women suffer from Thyroid problems. Thyroid Stimulating Hormone (TSH) is an important hormone produced by the Pituitary gland. TSH regulates the production and action of the Thyroid Hormones (T3 and T4). Estrogen and Human Chorionic Gonadotropin also affects the production of the thyroid hormones. Abnormal level of thyroid hormones in the body can result in Hyperthyroidism (increased production of thyroid hormones) or Hypothyroidism (decreased production of thyroid hormones by the thyroid gland). These conditions, if left untreated, can prove to be fatal for the mother and the baby.

Hyperthyroidism is greatly affected by an autoimmune disease, the Graves disease. The Thyroid Stimulating Immunoglobulin (TSI), produced during Graves disease, interferes with the production of the thyroid hormones. The TSI mimics the TSH to a great extent. This triggers the thyroid gland to produce the thyroid hormones in excess. A woman with hyperthyroidism may complain of increased heart rate, fatigue and increased blood pressure. There may be heat intolerance, tremor, sudden weight loss and Hyperemesis Gravidarum.

Untreated Hyperthyroidism can result in heart ailments, premature child birth, foetal Tachycardia, Preeclampsia (a pregnancy complication characterised by an abnormal rise in blood pressure) and miscarriage. In case of foetal and neonatal Hyperthyroidism, there is low birth weight, heart ailments, irritability and poor brain development.

Blood tests, whereby the levels of T3, T4, TSH and TSI are examined, can help in the diagnosis of Hyperthyroidism. Women with Graves disease should be extra careful. Antithyroid drugs can provide great relief. Most antithyroid drugs successfully cross the placenta and effectively regulate the production of the foetal thyroid hormone. Propylthiouracil (PTU) and Methimazole are effective anti-thyroid drugs.
Most doctors recommend Methimazole during the first trimester and PTU during the last two trimesters.
In case of Hypothyroidism, Hashimoto disease is the main wrecker in chief. This autoimmune disease results in considerable decrease in the production of thyroid hormones. Hypothyroidism can also be aggravated by Thyroidectomy (surgical removal of thyroid gland). Like hyperthyroidism, hypothyroidism during pregnancy can result in serious health complications. There may be stillbirths, congestive heart failure, miscarriage, anaemia, poor brain development of the newborn and Preeclampsia. Symptoms like cold intolerance, muscle cramps, concentration problems, fatigue or constipation should not be taken lightly.

Blood tests (T4 and TSH) go a long way to detect Hypothyroidism. A synthetic Thyroid hormone, Thyroxine, is effectively used to treat hypothyroidism. Including iodine supplements in your diet prove to be helpful in hyperthyroidism treatment.

Thyroid problems, though serious, can be successfully treated. A little alertness during pregnancy can shield both the mother and the newborn from the harmful consequences. In case you have a concern or query you can always consult an expert & get answers to your questions!

The removal of the uterus is known as a hysterectomy. This is a fairly common procedure and may or may not include the removal of the ovaries as well. A hysterectomy may be partial or complete and can be performed abdominally, vaginally or laparoscopically. A partial hysterectomy includes only the removal of the uterus and leaves the cervix in its place. A complete hysterectomy removes both the uterus and the cervix.

There are many reasons for women to undergo a hysterectomy. Treatment of uterine fibroids, endometriosis, uterine prolapsed and cancerous growths are the most common amongst these. There are alternatives to a hysterectomy in most cases and hence, a woman should know all the details about her case before undergoing such a surgery. The only case where hysterectomy is the only solution is in the case of cancerous growths.

The uterus does more than just act as a home for a growing fetus. Hence, the removal of a woman uterus can have a significant effect on her health.

Inability to bear children: For a woman in her thirties, the inability to bear children is the biggest effect of a hysterectomy. Some women may also experience a lowered libido. This is seen mostly in cases where the ovaries are removed along with the uterus. Some women may also face difficulties achieving an orgasm.

Anatomical changes: When the uterus is removed the spine compresses and makes the rib cage move downwards. This makes the hip bones move outwards and widen. As a result the anatomy of a woman changes to give her a wider waist and protruding belly. She may also lose a little height. Vaginal dryness is another physiological change that is triggered by a hysterectomy.

Surgical menopause: If the hysterectomy surgery includes the removal of ovaries, it is followed instantly by menopause. This is regardless of your age. If the ovaries are left intact, there is a risk of menopause occurring within the next five years. Some of the symptoms of menopause are:

• Hot flushes
• Depression
• Insomnia
• Fatigue
• Irritability and
• Vaginal dryness

Depression: Depression is a common side effect of a hysterectomy when it is performed on women in their thirties. The inability to bear children is partly responsible for this. This depression is usually temporary as long as the woman has a good support system in the form of friends and family. In some cases, this depression could also give rise to suicidal feelings. If you wish to discuss about any specific problem, you can consult a gynaecologist.

Intrauterine devices or IUD are T shaped contraceptive devices. These contain levonorgestrel or copper and are inserted into the uterus. IUDs are considered to be one of the most effective birth control measures and also they are reversible (meaning it can be removed whenever a need arises). The copper IUd has a failure rate of 0.8%, while the levonorgestrel IUD has only had 0.2% failures till now. As per a report in 2007, IUDs are used by more than 180 million users all over the world.

What you should know about Intrauterine devices:

1. Types of IUDs: There are 2 types of IUDs Copper and Hormone: Copper IUD is considered to be the conventional form of the contraceptive. It is T shaped with strings and is inserted into the uterus by a doctor. It can remain in the body for three to five years. Minera is a known brand of the hormone IUD. It contains low dose of hormone progestin and releases the same when inserted in the uterus. This is also T shaped and has strings. This can be left for three years.
2. Pelvic infections are not caused by IUDs: There is a belief that IUDs cause pelvic infection but this is not true. The strings of the new IUDs are very thin and they do not cause any pelvic infection even if a person is suffering from a sexually transmitted infection (STI). Though there might be a slight risk of infection when the IUD is inserted and in the first 20 days, but that also dissolves soon.
3. IUD can be used at any age: Earlier IUDs were not recommended for women who had never got pregnant. However, now anyone can use these irrespective of being pregnant or not. It is very safe for all age groups from teenagers to women involved in active sex to women post menopause.
4. IUD is as effective as getting a tubal ligation: It is believed that Minera is 99.4% effective while sterilization (tubal ligation) is 99% effective in preventing a pregnancy. Ligation is considered to be a permanent birth control solution, while IUDs can be reversed.
5. IUDs do not cause infertility: It was believed that a STI would creep into the pelvis through the string of the IUD and cause infertility but this is not so. Though a STI can cause infertility but the IUD has no role in the same and does not contribute or worsen the infection.
6. Hormonal IUD have less side effects than birth control pills: Breast tenderness, acne, and bleeding for a short time may persist for the initial 3-4 months in case of hormonal IUDs. The copper IUD lead to cramping and heavy flow during menstruation. If you wish to discuss about any specific problem, you can consult a gynaecologist and ask a free question.

Birth control pills commonly known as hormonal pills, oral contraceptive pills, or just pill's are an effective female hormonal birth controlling pill. Young women and adolescent girls are very frequently prescribed birth control pills for heavy or irregular menstrual flow, acne, PMS, hormone therapy, menstrual cramps. In Polycystic Ovary Syndrome (PCOS), which causes irregular menstrual flow due to hormonal changes, often birth control pills are given to lower the hormones and bring them within normal range. This also regulates the menstrual flow. Often adolescent girls who do not respond to acne treatment are prescribed hormonal pills. Also, these are given to girls who have endometriosis, irregular periods, and genetic conditions like Turner's syndrome.

Concerns associated with pills:

1) Do the Pills have any health benefits: Yes, it has benefits like treatment of PCOS, acne, regulates menstrual flow, decreases cramps, and lowers the risk of cancers and anemia (know more about anemia affect on health).

2) What are the side effects of the pill: Mostly it has no major problem as such. Pills containing estrogen might increase the risk of developing clots in eyes, lungs, and legs. If a woman complains of ACHES then she should be taken to the emergency.
A Abdominal pain
C Chest pain
H Headache along with dizziness and weakness
E Eye problems along with problems in speech
S Severe pain in the thigh or calf

3) Is there a risk of developing stroke or heart attacks while using the pill: A healthy woman who does not smoke and is on pills does not have any risk of getting a stroke or a heart attack. Smoking should be avoided when birth control pills have been prescribed.

4) Are there chances of getting cancer: Taking birth control pills actually protects the woman against ovarian and uterus cancer. Some experts also feel that the pill also reduces the chances of breast cancer.

5) Does the pill cause blood clots: Yes, there is little risk of developing clots in the legs. In adolescent girls the risk of forming clots is 5-50 per 100,000 every year. In pregnant women the risk is 4.3-10 folds more than those who do not use the pill.

6) Does the pill cause birth defects: The pill has not been associated with any birth defects and also does not harm the health of the child.

7) How does the pill help in irregular menstrual flow and acne: 
In case of irregular menstruation the pill helps by regulating the menstrual cycle to every 28 days. It also helps to reduce the amount and the length of the menstruation.

The hormones present in the pill help to stop the acne. OTC or prescribed drugs can be taken for moderate to severe acne.