Dr. Anita K Sharma

Are you experiencing excessive uterine bleeding? Excessive uterine bleeding may occur between a woman’s periods or before the periods, after having sex, or due to the development of spotting or bleeding after attaining menopause. Any menstrual cycle, which lasts longer than 21–35 days is called excessive, and this is an abnormal form of uterine bleeding.

Causes of Excessive Uterine Bleeding:

The various causes of excessive uterine bleeding are as follows:

1. One of the main causes is hormonal imbalance, as the balance between estrogen and progesterone gets disrupted. This balance is required for the regulation and development of the lining of endometrium or uterus lining. Because of the hormonal imbalance, the endometrium develops excessively causing heavy bleeding.

2. Uterine fibroids, which are non cancerous tumours, may lead to prolonged and excessive uterine bleeding.

3. Polyps are small benign developments on the uterus lining which cause heavy bleeding. They occur because of high levels of hormones.

4. Adenomyosis is a condition which develops when the endometrium glands get embedded in the uterine muscle, leading to excessive uterine bleeding.

5. Using intrauterine devices or IUDs may cause side effects as well.

6. Several pregnancy complications may also lead to excess bleeding. Ectopic pregnancy is a common cause.

7. Several uterine cancers, ovarian cancers and cervical conditions may be responsible as well. Inherited bleeding disorders such as von Willebrand’s disease is another likely cause.

8. Several medicines and drugs, including NSAIDs and anticoagulants, are a common cause.

9. Medical conditions such as pelvic inflammatory disease, endometriosis, liver and kidney disease or thyroid problems can also cause excessive uterine bleeding.

Treatment:

There are different ways of treating excessive uterine bleeding, depending upon the cause of bleeding and the patient’s age.

1. Medications: Several medicines are used for the treatment of abnormal uterine bleeding. Hormonal medicines and birth control pills are used to improve the regularity of periods. Nonsteroidal anti-inflammatory drugs are also used to manage excessive uterine bleeding. Several antibiotics are also used.

2. Surgery: In many cases, a woman has to undergo a surgery for the removal of polyps and fibroids, which cause excessive bleeding. Certain fibroids are removed via hysteroscopy and other techniques for treatment are used as well. Endometrial ablation can be carried out to manage the bleeding. This treatment aims at permanent reduction of the excess bleeding. Hysterectomy has to be carried out when other treatments are unsuccessful. This is a serious surgery and after it, a woman will no longer have periods, and she will not be able to conceive a child.

In case of excessive uterine bleeding, you must consult a doctor as soon as possible. This will enable early treatment and prevent the development of further complications.

When you’re trying to conceive a baby, waiting for your next period can be a test of patience. If your menstrual cycle varies from month to month or if you haven’t been keeping track of your cycle dates you may not even be sure of when your period is to begin. However, a missed period is not the only sign of pregnancy. Here are ten others signs to watch out for.

1. Sensitive nipples: As your hormone levels increase so does the blood supply to the breasts and nipples. This can make you feel extra sensitivity in the form of a tingling sensation around the nipples.
2. Nausea: Morning sickness affects most pregnant women but some women are spared this experience. Morning sickness can start as early as four weeks into the pregnancy and is marked by feelings of queasiness and an urge to vomit. Despite its name, morning sickness can affect a woman at any time of the day.
3. Frequent urination: A combination of surging hormones and a higher volume of blood in the body can make your kidneys work extra hard. From the 6th week of pregnancy onwards, women find themselves urinating more frequently. This may also be accompanied by a burning sensation.
4. Food cravings: Cravings for ice cream, pickles etc. is often joked about when it comes to pregnancy, but this can be one of the first signs of pregnancy. After conceiving a baby, a woman is likely to go off certain flavours even though they may be things she liked otherwise. You may also notice a metallic taste in your mouth and change in your sensitivity to the smell of things as well.
5. Tiredness: As the body gears up to nurture a growing fetus, mothers find themselves abnormally tired. Pregnancy hormones also add to this feeling along with making you upset and emotional. This fatigue is often highest in the first and third trimester.
6. Darker nipples: Pregnancy hormones can also cause changes in the appearance of your skin. One of the first noticeable changes is darkening of the nipples. Your nipples may also become more erect and the bumps around them may become more pronounced.
7. Spotting: It is easy to mistake light bleeding for a period, but if you are pregnant this is known as implantation bleeding. The reason for this spotting is not known but it occurs as the fertilized egg settles into the uterus. This spotting may also be accompanied by mild cramps.
8. Bloating: Pregnancy hormones can make you feel bloated especially in the abdominal area. This feeling is similar to the feeling some women have just before their menstrual cycle begins.
9. Mood swings: Pregnancy hormones affect neurotransmitters in the brain. For some women, this can cause heightened emotions while for others it can lead to depression and anxiety.
10. High basal body temperature: Basal temperature refers to your lowest body temperature and is usually taken as soon as you wake up. If your basal temperature has been higher than normal for more than two weeks consecutively, it may be a sign that you are pregnant.

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

The first question that comes to your mind when you think about intercourse during periods is “is it really safe?” The second thought that crosses your mind is whether it is something that you really should be doing?
Doctors have given a thumbs-up to sex during periods. If both of you are comfortable with it, then go ahead with it. If stained sheets are your main concern, you can always put a towel down and get on with it.

The other things you might want to know about sex during periods

1. You can still get pregnant: It is a common misconception that if you are on your periods, you cannot get pregnant. This is a myth. While the chance of that happening is grim, it is always better to be on the safer side and ensure you take proper protection.
2. It can be more pleasurable: While some may get awkward about the nitty-gritties, for some it can be immensely pleasurable. This is because the estrogen levels in the body drop on the first day, whereas, it starts shooting up by the 2nd day and that enhances your libido and your pleasurability may also increase. You will be more receptive to the touch and sensation.
3. How to make it less messy: If mess is the main concern, then you can minimise your pain and maximise your gain by using female condoms or menstrual cups to minimise the flow of blood. Other things you can do is have your man wear a condom or doing it towards the end of the period when the flow is comparatively lesser. Other things you can try are positions that involve you on your back and your pelvic prepped up (read missionary). Defying gravity!
4. Other options: So what if, your vagina will not be getting any action? We are lucky to have multiple pleasure spots. You can always wear a tampon to block the flow of blood and have your partner work on your clitoris. Hallelujah!

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

Malaria is a disease that is caused by the bite of a certain mosquito or protozoan parasite. This can attack the red blood cells and is mainly found in tropical as well as subtropical areas. Until recently, there was little chance of recovering from this ailment. Yet, in today's day and age of great medical advancement, it has become possible to cure a patient suffering from this disease with the help of timely and proper diagnosis. This disease becomes even more complicated and problematic when it affects pregnant women.

The ways in which this disease can be treated during pregnancy is as follows:

1. Medication therapy: If woman is found to be suffering from this disease in the second or third trimester of their pregnancy, they may be prescribed artemisinin-based therapy. This therapy can be used only if the pregnant lady is not suffering from any other kind of complications like heart conditions, diabetes and high blood pressure, during the pregnancy. This medicine is short-acting, with artemether or artesunate,which can greatly reduce the number of parasites that may have invaded the red blood cells.
2. Other antimalarials: The treatment of this disease for pregnant women can also be done with the help of other antimalarials, which should typically be prescribed and administered in a clinical setting. These also include quinidine gluconate which can be used in place of the IV quinine in order to bring down the number of parasites in the body. This will lessen the attack on the red blood cells to a great degree. Lumefantrine tablets may also be used in such cases. Also, the doctor will have to first try a test dose to ensure that the patient is not allergic to any of the elements or compounds of these medicines.
3. Monitoring: Pregnant women suffering from malaria will need to get their blood samples tested on a regular basis. The blood smears will usually be tested daily to check whether the body is responding adequately to the treatment. This will also ensure that the doctor knows when to change the dose or the drug involved.
4. Diet and exercise: The patient will be asked to stick to the normal diet and activity levels. Yet, care must be taken to avoid any situation where fatigue might set in, as this can aggravate the condition. One must also increase the intake of water to ensure that the body is always well hydrated. This helps the body in bouncing back to normal as the toxins are continuously flushed out, and the immunity system is better equipped to fight the disease causing parasites.

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

Recurrent pregnancy loss refers to the situation when three consecutive pregnancy loss takes place. A pregnancy loss is a clinically defined pregnancy which ends before twenty weeks.

Causes of recurrent pregnancy loss

1. Major cases of pregnancy loss occur due to genetic abnormalities and chromosomal abnormalities. The abnormality may occur from the sperm, egg or the early developed embryo.
2. Recurrent pregnancy loss may occur in a woman due to ascending maternal age. This happens because of poor quality of the egg, which further leads to chromosomal abnormalities. In some cases, the pregnant mother or the father can have some gene irregularities. In such cases, the would-be-born infant is affected, and this causes pregnancy loss or miscarriage.
3. Uterus abnormalities also lead to recurrent pregnancy loss. This may happen because of poor supply of blood to the uterus. Abnormalities in the uterus are in-born in some women and in others these may develop over time.
4. Women having a poor immune system are likely to suffer pregnancy loss. Abnormalities in hormone secretion like thyroid or diabetes may also cause pregnancy loss in women.
5. If a woman suffers from abnormalities in blood clotting, the chances of miscarriage are enhanced.

Testing for recurrent pregnancy loss
Several tests and examinations should be carried out for detection of pregnancy loss. 

1. Karyotype analysis of the woman and her male partner has to be conducted. Karyotype refers to the genetic or chromosomal constituents of an individual and this test is carried out to detect abnormalities in genes and chromosomes of the parents, which cause miscarriage when passed on to the developing infant.
2. Another test includes the evaluation of the uterus and the uterine cavity. This is done by ultrasound, saline ultrasound, MRI, hysterosalpingogram X –ray or by hysteroscopy. These tests help to get information on the uterus shape, about fibroid presence, detect abnormalities within the uterus and observe the opening and closing of the tubes. Tests to detect the functioning of hormones are also carried out.

Treatment
The treatment for women with recurrent pregnancy loss depends upon the underlying causes of the pregnancy loss.

1. In case of patients with karyotypic abnormalities, genetic counselling is recommended, where a specialist is consulted to know about chromosomal abnormalities.
2. Prenatal genetic studies are carried out by some couples to know about the offspring’s genetic make-up. This is done with chorionic villus sampling or with amniocentesis. A process known as in vitro fertilization (IVF) can be carried out.
3. In case of uterine abnormalities, a surgery may be performed and medications for reducing blood clot are used if antiphospolipid syndrome is detected.

Recurrent pregnancy loss may happen due to various reasons and proper tests, and treatment procedures should be carried out for curing pregnancy loss. This phenomenon affects a woman and her partner deeply. If you wish to discuss about any specific problem, you can consult a gynaecologist.

A rising number of teenage girls in the country are getting affected with Poly Cystic Ovarian Disease or PCOD. Though an advanced menarche has become very rampant these days, there are many young women who are suffering from a delay in menarche, which in turn is leading to PCOD as opined by gynaecologists. Obesity and sedentary lifestyle among young people have caused a rapid doubling of PCOD cases in the past five to eight years.

Occurrence and Symptoms:

Gynaecologists report that they get at least 15 fresh instances of PCOD cases and a considerable number of teenagers aged 16-17 are not getting their menarche. Such patients are recommended to take a strictly balanced diet, which will help them to lose weight. Initially, their mothers think that they would experience their menarche in proper time, but some girls are diagnosed with PCOD when taken to a family gynaecologist. Even worse, they could never imagine that their obesity can pave the way for such a grave health issue. PCOD can cause numerous other problems like delayed and irregular menses, rapid weight gain and tremendous difficulty in losing weight, developing acne and blocked skin pores. Furthermore, it leads to thinning of hair and excessive growth of hair on chest, back and face. Infertility, continual miscarriage, high blood pressure and high blood sugar are also common with PCOD.

Help yourself with the right diet:

There is no proven evidence regarding the cause of PCOD though gynaecologists are of the opinion that some females possess a predisposition to this disease and it may run hereditarily in the family. You can alleviate your PCOD symptoms to a considerable extent by regulating your diet properly. Have loads of fruits and green leafy vegetables and try to abstain from dairy products as many experts believe that dairy products are a direct cause of an increase in insulin levels, which can aggravate skin troubles along with other PCOD symptoms. Avoiding red meat and eating lean meat instead will help the condition and reduce the chances of infertility. It is always recommended to avoid hydrogenated and saturated fats, which are normally found in animal and dairy-based food. Try to put a stop to cheese, cottage cheese, clarified butter, pork, lamb, beef, etc. and certain baked products like cookies, cakes and fudges as they will trigger a rise in your blood sugar and cholesterol levels.

PCOD is such a condition, which you can never afford to overlook. If you had been facing any of the common symptoms, then it is probably time to pay a visit to a responsive gynaecologist.

PCOS (Polycystic Ovary Syndrome) is a common disease of the endocrine system among women who have attained the reproductive age. Women with this condition generally have ovaries larger in size than the usual, containing small pockets of fluids, also termed follicles. These 'follicles' develop in each of the ovaries as diagnosed with the help of an ultrasound exam. Abnormal or extended menstrual cycles, unusual growth of hair and obesity are some of the common accompanying conditions associated with PCOS. This disorder can interfere with a woman's menstrual cycles, thus making pregnancy difficult. More so, this condition can also impact the way you look and if left untreated for long, can lead to underlying disorders such as diabetes and other cardio vascular diseases.

Causes of PCOS:

1. Excessive Insulin secretion: Insulin is a hormone secreted by the pancreas, which allows the body cells to utilize the sugar; the most important energy store of your body. If you suffer from insulin resistance, your body's ability to utilize the insulin gets affected adversely. This forces the pancreas to secrete more insulin in order to keep up with the body's energy supply. This excess insulin might result in an increase in the production of androgen, which in turn, might interfere with the ovulation ability of the ovaries.
2. Low- level inflammation: Inflammation is the process by which your body's white blood cells fight infections. Studies reveal that women suffering from PCOS have a low level inflammation which acts as a catalyst in the production of androgens.
3. Can be hereditary: If you have someone in your family suffering from this syndrome, you might automatically be at a higher risk of developing this disorder.

Symptoms accompanying PCOS:

1. Abnormal menstrual is the most commonly observed symptom. Women suffering from PCOS may have less than nine periods in an entire year and in some cases, even none. 
2. Excess secretion of male hormone, which is related to excess androgen production may result in symptoms, such as abnormal body and facial hair, acne and baldness, which is identical to that in men.
3. Unexplained increase in weight and difficulty losing it as well.
4. Another fairly noticeable symptom is depression.
5. Infertility

A gynecologist is a doctor who deals with the health and well-being of the female reproductive system as a whole. These doctors usually deal with problems relating to all the organs of the reproductive system and issues faced while having a baby.

The most common reasons to visit a gynecologist are enlisted below.

• Menstrual irregularities - The menstrual health of any person is directly related to the overall health of that person. Ideally speaking, your menstrual cycle should have a regular and constant pattern. The common signs of having menstrual irregularities are periods lasting for more than 7 days, abrupt delay in the occurrence of periods, having extremely heavy or light bleeding during periods, missing a period, and such other issues.
• Breast problems - The breast problems which you might face at any point of time in your life may also be connected to having abnormal menstrual conditions. The common abnormalities seen by women in their breasts include breast discomfort during periods, abnormal breast changes, breast discharges, lump formations in breasts, and such others.
• Lower abdominal pain - Lower abdominal pain refers to any sensations of irritation and discomfort in the area above the pelvic region. The most common examples of this type of pain are menstrual cramps in the abdomen, lumps in the abdomen and abdominal pain during sexual intercourse. So if you see visible signs of discomfort and pain, then you should go to a gynecologist at the earliest opportunity.
• Pre-pregnancy counseling - A gynecologist is the most appropriate person you need to visit before you plan to have a baby. The doctor mostly recommends a complete health checkup so that you have a smooth pregnancy without any complications.
• General well-being - Gynecologists also take care of your overall vaginal health. It is very essential to have a healthy vagina for women, to ensure that it may not cause further health complications. Additionally, you may also visit gynecologists if you have breast cancer, ovarian cancer, cervical cancer or if you are experiencing symptoms of menopause.

'Consult'.

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