Author: Dr. Heena Chawla

Dr. Heena Chawla, one of the best gynecologists in Tricity has years of experience in the field as an OBGY. She also has experience in advanced laparoscopy and is presently working as a Senior Consultant at Apollo Clinic, SCO 10, 11, Madhya Marg, Sector 8C, Chandigarh.
She completes her fellowship in gynecology at the prestigious Institute Gujarat Cancer and Research Institute, Ahmedabad.

Her expertise includes:
1.) Infertility
2.) PCOS
3.) Laparoscopic surgery for gynae cancer
4.) Total Laparoscopic Hysterectomy
5.) Fibroid removal
6.) Ovarian cyst removal/treatment
7.) Endometriosis
8.) Gynaec cancers

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Apollo Clinic Chandigarh Gynecology

Fertility in women: Does Age Affect Female Fertility? | Does it Affect the Woman’s Health? | Right Age to Get Pregnant | मां बनने की सही उम्र क्या है ?

Fertility in women
Does age affect female fertility?

Fertility in women: Does Age Affect Female Fertility? | Does it Affect the Woman’s Health? | Right Age to Get Pregnant | मां बनने की सही उम्र क्या है ?

Fertility in Women,In this video, SimpliHealth expert, Dr. Heena Chawla, Consultant Gynaecologist Laparoscopic Surgeon at Apollo Clinics and CHD City Hospital, Chandigarh talks about  fertility in women through the ages. 

 

Does age affect female fertility

Age is a very sensitive issue for every woman. Neither female wishes to disclose their age nor wants to discuss it. But if we talk about fertility, age is a prime and essential factor. 

If I talk about the lifespan of females, after 11 -12 years, periods start commencing. After 18-21 years, one can plan pregnancy. Biologically, females attain maturity at 18-20 years of age. Still, they are ready for pregnancy by 22-23 years. But if we consider social factors like financial factors and job security, the females reach 26 -29 years of age when they think about marriage and pregnancy. But I’d like to talk about all these factors. 

What is female fertility? 

The essential thing for females is that they are born with a fixed number of eggs. The female child is born with 1-2 million eggs. However, there is no further egg formation after birth. The number of eggs remains the same. As the periods start commencing, the eggs start decreasing with age, and the females have only 3-4lacs eggs. By 40, the egg count reduces to 5k -10k. And by the time of menopause, the egg count had reached to 1000. 

Critical factors 

There are two critical factors in this: one is the count of eggs, and the other is an ovarian reserve. At how much time we can maintain our eggs or fertility window. Often in females, the fertility ovarian reserve starts reducing by 30. And decrease in the fertility reserve increase the risk of miscarriage. In addition, by the age of 35, there is an increase in the chances of congenital malformation in babies.

Risk factors 

Another thing is that if there is no risk factor involved in females, one can easily plan the pregnancy after 30 years. One is the egg number, and the other is the quality of the eggs. One can determine the genetic quality of eggs during the time of ovulation. If we talk about the age of 25, the monthly pregnancy rate is 20-25% if the female is trying to conceive. This percentage of females conceiving in a month reduces to 15% by 30 years. By the age of 40, it drops to 5%.

Diagnosis 

We can do an ultrasound, a critical test to determine the ovarian reserve. In this, we do antral follicle count (AFC). In this, we see the reserve of eggs. We can also do blood tests to determine the levels of hormones like LH, FSH, and anti -Mullerian hormone. Estradiol levels are also used to assess ovarian reserve. If the female doesn’t have a good quality of egg reserve, the doctors try to improve it by using some medicine and dietary modifications. But still, I would like to tell you that age plays a significant factor while conceiving. 

 

If the female is planning a pregnancy over-aged, they must consult with their doctor first, and if they need any supplement, they must take them. Also, one should take a proper blood test and take medicine accordingly, thank you. 

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Apollo Clinic Chandigarh Gynecology

Implantation Pain कब, कैसा और कहाँ दर्द होता है | Implantation Cramps vs Period Cramps | Is the implantation process painful? | How is the Pain Different From Period Cramps?

Implantation Pain
Implantation Pain

Implantation Pain कब, कैसा और कहाँ दर्द होता है | Implantation Cramps vs Period Cramps | Is the implantation process painful? | How is the Pain Different From Period Cramps?

Implantation Pain, In this video, SimpliHealth expert, Dr. Heena, Consultant Gynaecologist and Laparoscopic Surgeon at Apollo Clinic and CHD City Hospital, Sector- 8 Chandigarh, talks about the implantation process and answeres questions like: 

  • What is Implantation cramps or pain? 
  • Are these early signs of pregnancy? 
  • How can you differentiate it from cramps from periods? 

 

Where can one feel implantation cramps?

Implantation pain can occur in the lower abdomen as pain or cramps. By implantation, we mean the embryo travels through fallopian tubes to the uterus after fertilisation. Inside the uterus, it burrows towards the innermost layer of the uterus. By burrowing, fertilised embryo implants in the inner lining of the uterus. These pains may occur in the lower abdomen centre or may shift to the left or right side of the abdomen. If the female feels pain at the centre, it is probably implanting in the fundus or upper uterus. But if it’s implantation on the left or right sides of the wall, then the pain may shift to the left and right sides of the wall. Implantation may last for a few hours to 2 days. Mostly it heals on its own. Sometimes implantation pain may accompany spotting, which we usually call implantation bleeding.

 

Implantation bleeding 

There can be pinkish and brownish discharge during the time of implantation. It is not like severe pain. Instead, it’s mild cramps in the stomach. Avoid any painkillers during this time. Implantation cramps doesn’t cause any ill effects on the baby. 

 

How can we know that this pain is implantation cramps?

There is a specific time for this pain. It occurs after 6-12 days post ovulation. The embryo takes this much time from fertilisation to travel to implantation in the uterus. This whole process is 6-12 days. If the women’s cycle is 28 days and the ovulation occurs on 14 days, then most probably, the implantation pain will be at 20 -26 days. Or if the cycle is of 32 days, then ovulation would be on 18 days and the implantation pain 24-30 days. And in the prolonged cycles of 35 -40 days, the ovulation would occur near the 21st day, and pain would start in 27 to 33 days. 

Another crucial query that patients often ask is how we can differentiate implantation pain from period cramps.

 

How to differentiate between period cramps and implantation cramps

?

See, it is straightforward. Implantation cramps comes with early pregnancy symptoms, like tiredness, nausea, fatigue, constipation, mood swings, frequent urination, and lower back ache. And mostly, we are pretty familiar with periods of pain. Because we feel the same type of pain during every cycle, it also occurs before 1-2 days of onset. At the same time, the implantation pain starts from 6-12 post ovulation.

 

In contrast to periods, implantation pain occurs within five days. Also, period cramps mainly happen immediately on the onset of periods 1-2 days before. Also, period cramps are more severe since the uterus is a muscle structure. The contraction to shed up the muscle layer causes pain. It lasts for a long time. In addition, it is not necessary to have nausea, constipation, and fatigue during periods of cramps. Hence one can easily distinguish between period cramps and implantation pain.

 

Ultimately, in conclusion, being pregnant is another mode of meeting the love of your life. So enjoy this journey. Take care of your health. Be safe.

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Apollo Clinic Chandigarh Gynecology

Yoga in Pregnancy | Yoga in Pregnancy for Trimester | Yoga for Pregnant Lady for Normal Delivery | Yoga in Pregnancy First Trimester | Why is Yoga Important During Pregnancy? | गर्भावस्था के दौरान योग कितना अच्छा है? | क्या योग नार्मल डिलीवरी में मदद करता है?

yoga in pregnancy
yoga in pregnancy

Yoga in Pregnancy | Yoga during Pregnancy for Trimester | Yoga for Pregnant Lady for Normal Delivery | Yoga during Pregnancy First Trimester | Why is Yoga Important During Pregnancy? | गर्भावस्था के दौरान योग कितना अच्छा है? | क्या योग नार्मल डिलीवरी में मदद करता है?

Yoga in Pregnancy, In this video,  Dr. Heena Chawla, Consultant Gynaecologist at Apollo Clinics and CHD City Hospital Chandigarh discusses the benefits of yoga during pregnancy. 

These are a few questions that patients ask  whether they are in a nuclear family or joint family. Especially for those who reside in joint families, elders advise them to rest more and avoid excessive moments. But scientifically speaking, exercise and Yoga plays a vital role in pregnancy.

What are its benefits? 

First of all, doing any form of physical activity or Yoga uplifts your mood during pregnancy. It helps in reducing stress during pregnancy. As the body undergoes different types of stress during pregnancy, the mother’s health, baby’s health, and advice coming from every direction raise questions and anxiety. So Yoga and exercise will reduce this stress and anxiety to a much greater level. Yoga also helps reduce tiredness, weakness, and fatigue during pregnancy. It helps relieve lower back pain. It helps in improving the sitting posture to a much greater extent. In addition, it reduces leg swelling. And another thing often faced during pregnancy is constipation due to hormonal imbalance. Yoga helps in reducing the problem of constipation and Haemorrhoids that occur due to hormonal changes. Even regular Yoga helps in reducing nausea and vomiting.

Are pelvic floor muscles safe during pregnancy?

The issue of urinary incontinence, i.e., leakage of urine, is very common during pregnancy. Still, regular exercise, typically targeting pelvic floor muscles, reduces this problem to a much greater extent. In addition, in Yoga, during pregnancy, our muscles and ligaments get loose due to hormonal changes. As a result, their endurance and strength are compromised during pregnancy, but doing Yoga helps them bring them back. 

Does yoga help grow a foetus ?

Also, one significant benefit is blood circulation in mother and baby, which we call foetal-paternal circulation. Yoga improves this foetal placental circulation to a much greater extent. Also, the most significant advantage for any female is that it helps develop self-confidence and a positive attitude towards pregnancy.

 

Does yoga improve Sleep ?

Another significant complaint that often patients make is that they are sleep deprived during pregnancy. They develop a lot of sleep-related issues.  But Yoga helps restore the sleep pattern, and they may have a sound sleep at night. 

What is the recommended time for Yoga during pregnancy ?

Ideally, doctors recommend 30 minutes a day. However, if the females work or live in nuclear families can do less, that is also important. It increases the chances of normal delivery to a much greater extent. Also, in a few cases, doctors don’t recommend exercise, Yoga, or any form of physical stress during pregnancy to some patients. One must avoid physical stress if they have bleeding during pregnancy or a stitch in the cervix, which doctors mostly do for incompetent cervix. If the female has multiple pregnancies like twins or low-lie placenta which means the placenta is lying close to the mouth of the foetus or bursting water bags burst or if there is any other infection. So under these circumstances, doctors tell them to avoid Yoga, but yes, one needs to consult your gynaecologist and physiotherapist to start any form of exercise.

The baby also gains an essential advantage from Yoga. In mothers who are doing proper exercise or Yoga during pregnancy, the baby’s brain development is excellent compared to mothers who are not exercising or doing Yoga. However, one needs to take care of a few things like when we are doing some kind of exercise or Yoga, one shouldn’t go breathless during pregnancy. And one need to maintain good hydration one hour before, and must take our meals properly. And  must consult our yoga instructor or gynaecologist for exercise during pregnancy. 

For more information, visit SimpliHealth website.

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Apollo Clinic Chandigarh Gynecology Uncategorized

Endometrial thickness in periods and pregnancy | What is Endometrium?| Normal Endometrial Thickness for Pregnancy | Endometrial Thickness Chart | Thin Uterine Lining Symptoms | How to Increase Endometrial Thickness in 2 Days? | Pregnancy के लिए Endometrial Thickness कितनी होनी चाहीए ?

endometrial thickness chart

Endometrial thickness in periods and pregnancy | What is Endometrium?| Normal Endometrial Thickness for Pregnancy | Endometrial Thickness Chart | Thin Uterine Lining Symptoms | How to Increase Endometrial Thickness in 2 Days? | Pregnancy के लिए Endometrial Thickness कितनी होनी चाहीए ?

Endometrial Thickness for Pregnancy, In this video, Dr. Heena Chawla, Consultant Gynaecologist at Apollo Clinic and CHD City Hospital Chandigarh discusses about endometrial thickness and its role in sustaining pregnancy. 

The endometrium is the innermost layer of the uterus. Its thickness may vary according to the age or status of periods if they are coming or not. Females in which periods are coming, or start coming, the thickness of the endometrium is 2-4mm. Then after the end of the periods during 4 -7 days, the thickness of the endometrium increases to 5-7mm. During 11-14 days, the endometrium thickness rises to 11mm. Following 14 days, the next half of the menstrual cycle or luteal phase, the endometrium thickness increases to 13-14mm. For females who are not having periods, with no or less hormonal stimulation, periods stop coming, and then the normal thickness of the endometrium is 4-5mm.

 

How endometrial thickness helps in sustaining the pregnancy ?

The normal thickness of the endometrium, its receptiveness, proper blood flow, and proper nourishment are very important. Usually, the 7-8 mm endometrial thickness is perfect for pregnancy. If it’s much more than that, then it is better. Otherwise, 7-8mm of thickness is optimum for pregnancy. Now patients have thin endometrium thickness. Thin lined endometrium is most common in the ultrasound reports. Thin-lined endometrial thickness might lead to many problems like abnormal bleeding patterns, less bleeding during periods or painful periods, or difficulty in conceiving. Sometimes the patient is asymptomatic, and Doctors diagnose less endometrial thickness during an ultrasound. There can be various things associated with it. If estrogen levels in the body are less, then the endometrial thickness is less. If the uterus blood flow is improper, or the female had D&C or taking 21 days of oral contraceptive pills, or the endometrial tissue is unhealthy. Its nutrition is inappropriate, and infections like tuberculosis or pelvic disease might lead to a thin endometrial lining. If any surgery of the uterus or if the female is on medicine to enhance fertility like Chlormphim, it can also lead to thin-lined endometrium. 

What is the treatment ?

For its treatment, the first and foremost thing is diagnosis. Doctors do diagnosis by ultrasound. By ultrasound, doctors follow the growth of the endometrium, its thickness, its development during ovulation, and whether it is corresponding or not. The second thing is doctors do a hysteroscopy. Doctors insert a scope into the uterus and examine the inner lining of the uterus. Often due to the infection, there is the formation of adhesion, or inside the uterus, anterior and posterior walls may have stuck to each other, so doctors remove the adhesions in the same sitting, and then the endometrium starts growing normally. If there is an infection like tuberculosis or pelvic inflammatory diseases, then in these cases, doctors treat according to the condition. For tuberculosis, doctors prescribe treatment. For Pelvic inflammatory disease, doctors insert medicines. If the level of estrogen drops, estrogen tablets help in the treatment. 

 For more information, visit SimpliHealth website

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Endometrium Thickness In Pregnancy | Symptoms | Treatment | अन्तःगर्भाशय | कारण, लक्षण और उपचार

Endometrium Thickness In Pregnancy

Endometrium Thickness In Pregnancy : Causes, symptoms, and treatment 

Endometrium thickness in pregnancy, In this video, our SimpliHealth expert Dr. Heena Chawla, Consultant Gynaecologist at Apollo Clinic and CHD City Hospital at Sector 8 Chandigarh, is talking about endometriosis, its diagnosis, symptoms, and treatment. 

What is Endometriosis(Endometrium Thickness In Pregnancy)?

The endometrium is the innermost lining of the uterus. Endometrium thickness in pregnancy, This condition is called endometriosis when endometrial implants outside the uterus and start growing. Usually, during periods, the thick endometrial lining sheds off. But if the endometrial lining starts growing outside the uterus on a nearby organ, it doesn’t get any outlet. Due to this, the lining didn’t shed properly. Consequently, it causes pain, inflammation, and swelling. In addition, there is the formation of adhesion.

Causes of endometriosis:

The most common cause of endometriosis is retrograde blood flow (flow backward). The blood flow collects in the tubes or pools down in the ovaries. When it pools in the ovaries, it leads to the formation of an ovarian cyst. Sometimes the color of blood turns into a chocolate cyst. In a few cases, we see bluish-colored patches in the abdominal cavity. 

Symptoms of endometriosis

Painful periods (Endometrium Thickness In Pregnancy)

The most common symptom of a chocolate cyst or endometriosis is painful periods. As a result, it leads to severe dysmenorrhea or pain during periods.

Bloating

Patients may feel pelvic pressure with a bloating sensation. However, few may have severe pain while passing urine and excreting out. 

Infertility

Adhesion ruptures the relationship between ovaries and fallopian tubes. After eggs are released, it fails to reach the tubes. The second most crucial thing during endometriosis is that the egg’s quality is disturbed compared to normal women.

How to diagnose this condition?

Doctors may take the history and keep the symptoms’ records for proper diagnosis. Through clinical study, doctors get a lot of information about the condition. For example, during the ultrasound, ovarian cysts are the most common finding of endometriosis. Doctors draw definitive diagnoses by laparoscopy. However, deep filtration of endometriosis can also be seen in MRI. 

Treatment

The treatment of endometriosis dramatically depends upon the symptoms. If you only have pain, then doctors prescribe painkillers. In case of heavy bleeding, doctors may give medicines to control bleeding. If the patient isn’t getting help from other treatments, we use 21 or 24 days of contraceptive pills. Under adverse cases, doctors prescribe Gonadotropin GnRH analogs to suppress endometriosis. 

Hysterectomy: Yes or No

If the patient desires fertility, doctors only remove the ovarian cyst and restore the relationship between the tubes and ovaries to help the pregnancy. Also, doctors separate the adhesions and burn the endometrial patches. And if the patient doesn’t want to get pregnant or is overaged, doctors advise a hysterectomy or removal of the uterus. 

Bottom line:

If you have this endometriosis condition, don’t feel hurt; seek a doctor’s advice. Discuss with the doctor your symptoms and plans for pregnancy accordingly; the doctor can plan the treatment. 

Thank you

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Apollo Clinic Chandigarh Gynecology

Treatment For Cervicitis | सर्विसाइटिस क्या है | Symptoms | Treatment

Treatment For Cervicitis

Treatment For Cervicitis: Causes, Symptom and Treatment 

Treatment For Cervicitis, In this video, Dr. Heena Chawla, Consultant Gynaecologist at Apollo Clinic and CHD City Hospital Chandigarh discusses cervicitis. The mouth of the uterus is called the cervix. It is a condition with an infection or swelling in the mouth of the uterus or cervix. It may vary from acute to chronic infection.

What are the probable causes of cervicitis?

Bacterial and chlamydial are two main infection reasons for cervicitis. In 40% of the cases, chlamydial infection is a causative agent. Treatment for cervicitis, Besides, gonorrhea, bacterial vaginosis, and Herpes Human Papillomavirus also contribute. In addition, specific non-infectious reasons like allergy to tampons and douching might cause itching. Generally, contraceptives (condoms and Copper-T) can lead to inflammation.

What are the common symptoms of cervicitis ? 

The first and foremost symptom is vaginal discharge. Its color may vary from white and grey to yellow. Above all, there is itching. Often patients complain of excessive and persistent itching. Few may have lower abdominal pain or backache. There is a possibility that one may not have any of the above symptoms. Contrarily they might feel pressure in the pelvis. Lastly, severe infection can cause fever.

How to diagnose it(Treatment for cervicitis)?

First, doctors perform clinical examinations of the patient. The clinical study includes a type of discharge and may recommend a few tests. A microscopical examination of discharge clearly gives the clear picture of causative agent. The doctor may advise Pap Smear Test. If the patient has a chronic infection, then doctors do a vaginal culture swab test.  It identifies the type of infection and suitable antibiotic.

Treatment

Depending upon the type of infection, the doctor gives treatment. Doctors prescribe antibiotics for bacterial infections and medicines for viral infections. Medicine can cure this.

Complications

If left untreated acute cervicitis  might turn into its chronic form. If it stays, then the infection of the mouth of the uterus may ascend to the upper areas of the uterus like fallopian tubes which we call salpingitis, or may come inside the uterus. This syndrome is called PID or pelvic inflammatory disease. This might lead to difficulty in conceiving and may lead to infertility.

Bottom line 

If you have any of these problems like unusual discharge or itching, you must consult your doctor and seek treatment. 

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Apollo Clinic Chandigarh Gynecology

C Section Delivery | Cesarean Delivery(सीज़ेरियन सेक्शन डिलिवरी का कारण)

C Section Delivery

What are the common reasons for C-section delivery?

C Section Delivery, In this video, Dr. Heena Chawla discusses reasons for cesarean delivery). She has raised all the curtains from the myth about C Section Delivery. People are always in a dilemma about C-section delivery and blame the doctor. But there are certain indications or reasons for C-section delivery. One of the medical conditions that doctors often face in females is structural deformity or presence of short bone.

What is a short bone in females?

 Presence of short bone called cephalopelvic disproportion, or when the doctors don’t see the baby’s head or crowning. It serves as one of the common reasons for.

What is the baby’s indication of a reason for C Section Delivery ?

Sometimes the baby is in a breech position, like the baby’s head is upwards. And sometimes ultrasound finding reports the baby is in stress. Under these conditions, doctors don’t opt for normal delivery.

How does placenta position affect delivery?

Few females develop medical conditions like low-line placenta. In a few cases, the placenta almost completely covers the mouth of the uterus or cervix. So doctors don’t take chances of normal vaginal birth as it may pose a risk to mother and baby.

Other reasons for C Section Delivery.

In a few cases, doctors take chances for normal delivery. For example, under conditions of non-progress labor where the cervix is not open sufficiently, doctors opt. 

What if the baby passes meconium in fluid?

In case the baby has passed meconium or has a problem with the baby’s heartbeat. Also, it makes the baby difficult to breathe. Due to the meconium, there is less oxygen in the fluid.

So these conditions also compel doctors to opt for Cesarean Delivery).

How do multiple pregnancies become a reason for C Section Delivery ?

Multiple pregnancies like twins or triplets, are also indications for caesarean or C-section. What is induced labor?

Doctors’ plan induced labor when the female is overdue or there is a fluid leakage due to circumstances. Even with any kind of bleeding, doctors induce labor pain in the patient. But this is an artificial method, and the female’s body doesn’t respond to these artificial medicines. Hence there is not enough dilatation in the uterus to support vaginal birth. So under these circumstances, doctors opt for cesarean delivery) to save the baby’s life.

How does the medical condition in women become the reason for C Section Delivery ?

Sometimes a mother’s underlying medical condition like heart disease or diabetes, also indicates cesarean delivery). Even a condition of bp might lead to C-section.

Must one be scared of Cesarean Delivery?

C-section deliveries are very safe. Doctors do these by keeping in mind the safety of both mother and the baby. 

What is the recovery time for Cesarean Delivery?

It takes almost six weeks for the internal stitches to heal. Skin stitches may heal after 7-10, and sometimes doctors remove them within a week. And if the stitches are dissolvable, they heal, but the internal stitches require at least six weeks to heal.

Bottom Line 

 So during this period, females need to take utmost care of themselves. Take bed rest. Take medicines correctly, as six weeks is crucial for healing internal stitches.

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How Many C Sections Can A Woman Have ? | सीज़ेरियन सेक्शन | Is It A Safe Procedure ? Recovery Time ?

Number of C Sections or Cesareans by Dr. Heena Chawla

How Many C Sections Can A Woman Have ? Is it a safe procedure? And recovery after C Section 

How many c sections can a woman have? In this video, SimpliHealth expert Dr. Heena Chawla, Consultant Gynecologist at CHD City Hospital, Chandigarh, is talking about the risks involved in C sectio. She aslo answers common questions like: 

  • How many cesarean sections are possible for women? 
  • What is the maximum number of cesarean possibilities? 
  • What are the risks associated with cesarean section? 

How many C section can a woman have?

It’s very difficult to say how many C-sections a woman can undergo. Many females have undergone five to seven cesarean sections, and few have complications after one cesarean. 

So every patient is different; hence we need to individualize it for everyone. 

For every patient, we need to set other criteria. Like this patient can undergo a cesarean or not. 

Risks involved in C section 

The incidence of cesarean was 15% in early times; then, it gradually increased to 25%. Increased maternal complications and fetal risk are the most probable reasons for the rise in cesarean delivery. However, every cesarean comes with few risks. 

Adhesions (How Many C Sections Can A Woman Have ?)

Adhesions form after every surgery, like the anterior abdominal wall or the intestine sticking to each other, and the omentum may stick together. 

Injury to nearby organs 

Whenever we do any operation, there is an increase in the operative time, and the risk of injury to the nearby structures also increases. 

Damage to urinary bladder 

Damage to the urinary bladder is always one of the risks during a cesarean, and this risk factor increases with every cesarean. 

Stitches and chaces of rupture 

Also, we make a scar or incision in the uterus during a cesarean and then stitch. Eventually, these stitches heal, so there is a probability of developing weakness in these areas. As the pregnancy increases as the baby grow, it puts pressure on the weak spots, resulting in more weakness and increased chances of rupturing. 

Mothers are at very much risk if there is suppuration in the uterine layer. 

Accreta 

Apart from this, often placenta may stick to the scar area and may start growing there, this condition is known as accreta, which may invade the uterus wall and start growing there, or it may come out and start growing in the bladder. 

Post Partum Hemmorhages 

And there is a probability of a low-line placenta which means it is more towards the lower side. So this situation may result in excessive bleeding in the next cesarean. As a result, there are more chances of bleeding and PPH. 

There is an increased risk of blood transfusions. If we cannot control bleeding in the patient on the table, irrespective of trying all methods to save the patient’s life, we might need to perform a hysterectomy.

The risks depend on the previous pregnancy. 

So these are a few risk factors associated with recurrent cesarean section. 

  • As the number of cesarean sections increases, these complications also increase.
  • Apart from this, it also depends on the condition of the previous pregnancy. 
  • If in the last pregnancy, there were complications in the wound. 
  • Or the stitches did not heal well correctly. 
  • Stitches came out before the time or duration of hospitalization. 

Risk of Hernia 

Was there any bleeding or injury to the nearby structure, or did some patients develop a hernia? 

Suppose someone has undergone more than two cesareans, then the probability of developing hernia increases to three times. 

If someone has six cesarean sections, there is six times more risk of developing a hernia. Also, it largely depends upon the type of incision made to the uterus. Some may provide vertical incisions. 

How to decide for a C section 

In such cases, we don’t decide to do cesarean delivery for the second time easily. So all these factors are taken into consideration. If the current pregnancy is high-risk, we count all the factors to consider whether to opt for a cesarean section in the following delivery or not. And if you don’t have a high-risk pregnancy, it is a low-risk pregnancy. 

You didn’t have any problems the last time; the previous cesarean was uneventful, recovery was good, and there was no problem healing the stitches then. We can easily decide on a cesarean section for the subsequent pregnancy.

How many C sections are safe? 

 If I have to say a standard figure, then I would say three cesareans are very safe, but therein is an increase of risk with each passing surgery.

 Thank you 

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Treatment For Blocked Fallopian Tubes | अवरुद्ध फैलोपियन ट्यूब के लिए उपचार

Blocked Fallopian Tube Ko Kaise Kholen

Treatment For Blocked Fallopian Tubes | Symptoms of Blocked Fallopian Tubes

Treatment for blocked fallopian tubes, In this video, SimpliHealth expert, Dr. Heena Chawla, consultant gynecologist at Apollo Clinic and CHD City Hospital is talking about the treatment for blocked fallopian tubes. 

What are the treatment options available for blocked tubes?

When we do HSG, it helps open any proximal blockage of tubes. Apart from this, if the tubes are healthy, we try to open them by laparoscopic procedures. More commonly known as tubal cannulation. 

Tubal cannulation is a very easy procedure. 

Factors to assist before surgery : 

But before doing this surgery for fallopian tubes, it is very important to assess the other factors. Like ovaries are functioning correctly or the husband has normal sperm counts. 

If there is a problem in the husband’s sperm count, or if I say there is impairment in the formation of eggs in the ovaries; then instead of going for laparoscopic procedures for fallopian tubes. We must directly opt for IVF which is In-vitro fertilization. 

IVF 

If there are other factors also contributing to infertility, then in these cases, IVF helps a lot. But if there is water filled in the tubes, then the success rate of IVF is reduced to 50% in the hydrosalpinx condition. 

So under these circumstances, we either remove the tubes or clip them off. Or chip off their communication with the uterus. By doing this, we can increase the success rate of IVF to a great extent. 

If you have any questions regarding this topic, please write in the comment box.

 Thank you 

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Symptoms of Blocked Fallopian Tubes | अवरुद्ध फैलोपियन ट्यूब के लक्षण | कारण एवं उपचार

Symptoms of Blocked Fallopian Tubes

Symptoms of Blocked Fallopian Tubes | कारण एवं उपचार

Symptoms of blocked fallopian tubes.In this video, SimpliHealth expert Dr. Heena Chawla, Consultant Gynecologist at Apollo Clinic and CHD City Hospital, Chandigarh is talking about the causes and diagnosis of blocked fallopian tubes. 

Where are fallopian tunes situated?

We will understand where fallopian tubes are situated. Along both sides of the uterus are two thin tubes we call fallopian tubes. 

Function of a fallopian tube 

Symptoms of blocked fallopian tubes,Their function is to carry the egg released by the ovary. Inside these fallopian tubes, a brush-like cilia helps move eggs inside tubes from the ovary, and sperm travels into tubes. They both fuse in fallopian tubes and undergo fertilization. After the fertilization, the embryo travels to the uterus and implants itself.

Importance of an open fallopian tube 

Healthy and open fallopian tubes are two important parameters for pregnancy to sustain. Unfortunately, often due to some reason, there is a blockage in either one or both fallopian tubes. For any couple trying for pregnancy but cannot conceive, one-third are affected with blocked tubes.

Causes of Blocked Fallopian Tubes

STDs (Symptoms of Blocked Fallopian Tubes)

Any pelvic inflammatory disease (PID) or one with a history of tuberculosis or sexually transmitted diseases like gonorrhea or chlamydia may result in blockage of tubes. 

Surgeries (Symptoms of Blocked Fallopian Tubes)

Any previous surgery could be ectopic, or other surgery on tubes might also lead to blockage. Often different things like during endometriosis, the layers stick to each other, and there is the formation of adhesions, which blocks the lane; hence the egg doesn’t find its way out in tubes. 

Infections 

Apart from this, we often see some infections that may result in the blockage of tubes after any surgery like abdominal surgery or miscarriage, or DNC.

Can the woman conceive with one blocked fallopian tube?

Another common question patients ask is whether we can conceive with one fallopian tube as there is a blockage in the other.

See if there is a blockage in one tube, but the other is open and healthy. There is no other reason for not having a sustainable pregnancy. Like egg formation is good in ovaries, the egg is of good quality, there are no further problems in the uterus, and the husband’s sperm count is average; then, under these circumstances, the patient may have sustainable pregnancy with one fallopian tube. 

There are no decreased chances. The patients have relatively the same chance of having pregnancy compared to those who have both healthy fallopian tubes if other parameters are normal.

DIAGNOSIS OF BLOCKAGE OF TUBES

Now we will understand how we can diagnose this condition. 

Ultrasound test

Often in ultrasound, you might have come across the term hydrosalpinx, which is the condition of water filled in tubes. Usually, patients do not show any symptoms of blocked tubes until and unless they start trying for pregnancy. Then only doctors do some test that shows blockage in tubes. 

Those with hydrosalpinx conditions may also have vaginal discharge, or we make an ultrasound diagnosis and start their treatment. If they respond to the treatment, it is a very good thing. 

HSG test (symptoms of blocked fallopian tubes)

For couples with blockage in tubes or who are trying for pregnancy under these circumstances, we recommend a simple OPD test, hysterosalpingography, or HSG test. We usually do this test 5 -10 days after periods. 

We count the first day of period onset as day 1; then, we do it between 5-10. In addition, we do it in the first half because there might be a chance of pregnancy after conceiving. So that’s why we conduct this test in the first half.

How does an HSG test work? 

Usually, we insert a dye in the uterus, and via tubes, it comes out. It gives us a clear picture of whether they are healthy or not, open or closed. 

Often females may experience mild cramping in this, so we prescribe pain killers to them in advance, and simultaneously we take an X-ray film so that we have a complete picture clear about the status of the tubes. It also gives information about the uterus. Often, when there is very much blockage in tubes; then this test can be very painful since the dye can’t move forward because of the blockage. 

Since fallopian tubes have many parts, if there is a small blockage in the proximal region, it might get open because of the dye. Therefore, the HSG test is a very useful and informative test that we usually conduct in infertile couples. 

Sonosalpingography test 

Apart from this, there is another test, sonosalpingography, in which we do an ultrasound simultaneously when injecting the dye inside. We can visualize any fluid, if it is coming with dye or not while conducting the test.

Chromopertubation test 

Apart from these, we have another test, laparoscopic confirmation or Chromopertubation. We visualize through the stomach, insert the dye through an endoscope, and check whether the dye is coming out or not from the tubes. If the dye comes out, then the tubes are open; if not, there is a blockage somewhere. 

We perform this test under anesthesia, and it’s a daycare procedure; if we do it in the morning, you may leave by the evening. By laparoscopic examination, we can see the other things like ovaries and uterus in the same sitings. 

Which test is the most accurate? 

Often patients see tube blockage in HSG, but it is essential to reconfirm it further. Because when we do HSG or laparoscopic for the second time, around ten patients were previously diagnosed with blocked tubes. Six may have open tubes after doing laparoscopy and HSG

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How to Stop Bleeding During Pregnancy | गर्भावस्था में खून बहने के कारण : Ectopic Pregnancy

Bleeding in Pregnancy

How to Stop Bleeding During Pregnancy | गर्भावस्था के दौरान रक्तस्राव कैसे रोकें एवं कारण

How to stop bleeding during pregnancy, How to stop bleeding during pregnancy, In this video, SimpliHealth expert, Dr. Heena Chawla, Consultant gynecologist at Apollo Clinic and CHD City Hospital, Chandigarh, is talking about the reasons for pregnancy bleeding and ectopic pregnancy and answers questions like: 

  • What are the causative reasons for pregnancy bleeding? 
  • Is every bleeding that occurs in pregnancy a sign of miscarriage? 
  • How can we infer that this bleeding leads to miscarriage or will heal on its own routinely? 

Bleeding in pregnancy is a very common condition. Almost 20 % of pregnancies are associated with bleeding. Statistically, 2 out of 10 result in bleeding during pregnancy. 

Types Of Bleeding During Pregnancy

We will discuss the types of bleeding during pregnancy in detail. 

Implantation Bleeding | How to Stop Bleeding During Pregnancy

First is implantation bleeding. This type of bleeding occurs after fertilisation; the embryo implants itself towards the inner lining of the uterus, i.e., on the endometrium. This implantation may result in spotting, but this bleeding usually occurs before the missed period. Precisely this bleeding occurs within 6-7 days of ovulation. And usually, it lasts for 1 -2 days maximum, it is light pink, and this does not require any treatment. 

Usually, we advise our patients to go for a pregnancy test whenever they miss their periods. If the test is positive, we can carry out a normal pregnancy. If the pregnancy test is positive and then it is bleeding, then we need to be cautious. Under these circumstances, we must consult our gynecologist as it could be an early sign of miscarriage. 

Threatened abortion 

Often the fetus may get separated from the endometrium a little, and all other parameters of the fetus are normal. Then this condition is called a threatened abortion. There is separation but not to that extent, so we give progesterone injection to support the implantation and advise rest. 

Signs of miscarriage 

Eventually, it gets settled. Apart from this, sometimes pateitns may have heavy bleeding, or there are clots, or they are having cramps, so these could be a sign of miscarriage. Still, we need to check whether the foetus is adequately expelled from the uterus after separation or not. Is it incomplete separation or complete? If it is incomplete separation, it may result in heavy bleeding, ultimately causing infection in the uterus. 

So for this type of bleeding, we must consult our doctor. Usually, whenever you are heavy bleeding accompanied by clots and intense cramps, it gives an idea of miscarriage. 

Subchorionic Hematoma

Apart from this, one other thing you must have read in ultrasound is a subchorionic hematoma. In subchorionic hematoma, there is blood pooling, resulting in clots between the foetus and the inner lining of the uterus. If the clot is small in size, we try to treat it with medicines and progesterone injection for support, and gradually it settles. But if the size of the clot is large or there is a big size hematoma, then there is an increased chance of miscarriages. 

Ectopic Pregnancy 

Apart from this, there is another important condition called an ectopic pregnancy. 2 out of 100 pregnancies could be in the fallopian tube, ovary, or any other place but not the uterus. We call this condition ectopic pregnancy. This pregnancy test would come positive, but the patient may have bleeding, intense pain, and dizziness. 

If you observe any of these signs, then it is an emergency condition because the diameter or lumen of the tube is tiny; it is self-evident the foetus can’t grow in tubes. In severe cases of pregnancy, there is a rupture of tubes resulting in the pooling of blood in tubes leading to life-threatening conditions. Under these circumstances, we must consult our doctor and get treatment accordingly.

Molar Pregnancy 

 Another condition is a molar pregnancy. This type of pregnancy is very rare, but the tissues present in the placenta wall are overgrown. Dense tissues in the placenta wall might result in bleeding, and sometimes bleeding may occur even after the DNC. There is recurrent bleeding after repeated DNC., so we suspect molar pregnancy under these circumstances. We need to discontinue the pregnancy as there is repeated growth of molar or abnormal tissues. 

Other Reasons For Pregnancy Bleeding 

Lastly, there are a few reasons, like infection in the cervix, which is the mouth of the uterus, which might result in bleeding. For this, we prescribe medicine and antibiotics to settle this bleeding. The most important thing that I want to convey is that if you are bleeding during pregnancy, you must consult your gynecologist, get your ultrasound, take medicine, and don’t ignore this condition.

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Symptoms of Anovulation | एनोव्यूलेशन के लक्षण | Anovulation Bleeding | महिलाओं में अंडा नहीं बनने का क्या कारण है? | एनोव्यूलेशन के लक्षण, कारण और उपचार?

Symptoms of Anovulation

Symptoms of Anovulation | Signs of Anovulatory Bleeding | Anovulation bleeding | महिलाओं में अंडा कब फूटता है? | पीरियड के बाद अंडा कब निकलता है

Symptoms of ovulation (ओवुलेशन होने के लक्षण), In this video, SimpliHealth expert, Dr. Heena Chawla , Consultant Gynecologist at Apollo Clinic and CHD City Hospital, Chandigarh, is talking about Anovulation, ओवुलेशन होने के लक्षण and the causes of ovulation failure. 

What it is Anovulation?

Anovulation is a condition when ovulation does not take place. Symptoms of Ovulation (ओवुलेशन होने के लक्षण) During the normal process, inside our brain is the hypothalamus which secretes Gonadotropin-releasing hormones. These hormones act on the pituitary gland and release other such hormones responsible for the formation of follicles during the first ten days of the cycle after menses inside the ovaries. Then after some time, these follicles mature. 

Later,  after maturation, one follicle matures, and in the later stages, the egg ruptures. This process is called ovulation. Before ovulation, the secretion of luteinizing hormone increases significantly, leading to ovulation. After ovulation, there is an increase in progesterone concentration in the body. If by any means this process of ovulation is hampered. 

Reasons associated with Anovulation

There can be many reasons associated with this. There can be problems in the pituitary gland, some issues related to the hypothalamus, or an imbalance of hormones. All these hormones present in the body, like thyroid hormone, prolactin hormone, FSH hormone luteinizing hormone, are interrelated. If there is an imbalance in these hormones, like the pituitary gland dysfunction, then there is a delay of cycles, or the cycle is irregular or happens for fewer days. 

When there is a complete failure of the pituitary gland, like in some cases, the menstrual cycle does not occur, or they start and eventually stop after six months; we call this secondary amenorrhea. Ovulation failure is very common in these patients.

Symptoms Of Ovulation Failure

The patient often visits OPD with two main symptoms of ovulation failure. 

Irregular periods Symptoms of Ovulation (ओवुलेशन होने के लक्षण)

The first is irregular periods that we recently talked about, and the second is they come with infertility. Infertility means they are unable to conceive. Often patients come to the OPD and tell that they have been trying for an extended period, but they cannot conceive. So this state is a chronic anovulation phase in which ovulation is not occurring. 

Usually, we see that two or three cycles of ovulation are not happening in one year, and it may start again. So we call this condition an irregular cycle. But if there is chronic anovulation or completely no ovulation, this becomes one of the causes of infertility. 

PCOS 

Apart from hormonal imbalance, PCOD is a condition in which anovulation is very common. In PCOD, there is weight gain, facial hair, especially hair close to the jawline, onset of face acne, and an irregularity in periods. 

Endometriosis 

Apart from this, if you have been diagnosed with endometriosis, the quality of the egg deteriorates to a greater extent, and there is a complete disturbance in the ovulation pattern. 

Other Factors 

In some cases, excessive exercise may also disturb the pattern of ovulation. Secondly, if you are overweight, obesity, we say, is one of the most common factors in disturbing the process of ovulation. 

How Do You Determine The Ovulation Time? | Symptoms of Anovulation 

Now, how do we know that ovulation is about to happen? First, the body gives certain signs before ovulation. 

Body Temperature 

If we can monitor them clearly, then we can deduce whether the ovulation is about to occur or not. For this, we can measure the basal body temperature. Usually, there is a slight increase in body temperature during ovulation. But we need to measure it at the same time of the day and on an empty stomach. Because consumption of fruits or anything hot or cold or doing heavy exercise can alter the body temperature. 

Cervical Mucus 

The second thing is cervical mucus. During ovulation, the cervical mucus or vaginal discharge becomes sticky, transparent, and visualized just like a wire; if we note this type of discharge, we can predict the time of ovulation, or it will not happen. Apart from this, LH surge detection kits are available in the market. Using these kits, we can determine the time of ovulation, like when there is a rise in the luteinizing hormone inside the body. So these kits can detect the surge of the luteinizing hormone. But until and unless we confirm that ovulation has occurred. We can’t surely say that the ovulation process has happened or not.

Ultrasound Follicle Monitoring

There is another method known as ultrasound follicle monitoring, in which we continuously monitor the follicles to determine whether the ovulation has happened or not. The incidence of anovulation is about 30%. If I say 30% of body cycles are anovulatory and are the main reason for infertility. For their treatment, we have medicines that induce ovulation. 

Causes Of Ovulation Failure

Sometimes we see patients taking contraceptive pills for a longer duration or those who are taking 21or 24 days pills. So the condition of anovulation is also very common among them. Because the mechanism of these medicines is to suppress the ovulation cycle. 

If you have any of these problems, or if we could do regular exercise or reduce stress. And those who are overweight should reduce their weight. Those who perform heavy workouts should ease out their exercises and do them in ample time. 

And if you are unable to conceive, then you must consult your doctor. And must take medicines for anovulatory cycles. 

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Endometrial Cancer Treatment | गर्भाशय कैंसर का इलाज | एंडोमेट्रियल कैंसर Stages & Treatment

Endometrial Cancer Treatment

Endometrial Cancer Treatment (एंडोमेट्रियल कैंसर): Stages and Treatment

In this video, SimpliHealth expert, Dr. Heena Chawla, a Consultant Gynecologist at Apollo Clinic and CHD city Hospital, Chandigarh talks about endometrial cancer treatment. She also talks about endometrial cancer stages and endometrial cancer treatment. 

DIFFERENT STAGES OF ENDOMETRIAL CANCER:

Endometrial cancer is divided into four stages:

Stage one (Endometrial Cancer Treatment)

In the first stage, the tumor is restricted to the innermost or muscle layer of the uterus only. It has not spread into nearby locations. 

Stage two 

The second stage of endometrial cancer has reached the mouth of the uterus i.e. the cervix or cervical stroma. But it has not gone outside the uterus. 

Stage three 

In the third stage, cancer extends to the outside of the uterus but remains confined to the pelvis. By pelvis, I mean it is limited to either ovary, fallopian tubes or round ligament, and if it grows further, it will move to lymph nodes. Lymph nodes are small vessels on arteries and veins, either pelvic or para-aortic lymph nodes. This is our third stage. 

Stage four

Finally, cancer spreads outside the pelvis in the fourth stage of cancer. It can be in the lungs or bone or has metastasized into any other body organs, which the doctors call distant metastasis. In this stage, it starts spreading into adjacent organs of the body. 

Now the doctors will talk about its treatment.

TREATMENT OF ENDOMETRIAL CANCER

Surgery 

The doctors can diagnose this uterine cancer early in most cases because most patients present heavy bleeding. If the doctors can analyze it early, the essential part of the treatment is surgery. In surgery, the doctors remove the uterus, ovaries, tubes, and lymph nodes present in arteries and veins. And wherever the doctors see cancer has moved in the abdomen, they remove it. So surgery is the most important aspect of the treatment of endometrial cancer. The specialists should consult a cancer expert or expert gynecologist for this type of surgery as they require staging surgery. 

Radiotherapy 

So this surgery is critical. Other treatment modalities are radiotherapy, in which the expert expose a laser to stop the cancer cell division. Chemotherapy is another treatment option for endometrial cancer.

Medication 

The specialists use a specific type of medicine to stop cell multiplication. With the latest advance, they have hormone therapy. Since the imbalance of hormones has led to this situation to combat, they use certain hormones to overcome the effect of others causing imbalance. 

Targeted therapy 

Apart from this, the doctors give targeted therapy. As the name suggests, they target only the cancer cell, stop their multiplication, and inhibit their growth. Largely the treatment of cancer depends upon the stage of cancer. 

Often patients require the need of further treatment after surgery. But all these things depend upon the stage of cancer, type of surgery, and other modalities of treatment that will benefit them and increase the survival rate. You need to discuss this with your doctor in detail and make the best decision about the most suited treatment plan.

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Endometrial Cancer Symptoms | (गर्भाशय) बच्चेदानी में कैंसर के कारण, लक्षण व इलाज

Endometrial Cancer Symptoms

What is Endometrial Cancer Symptoms? Its Signs, Symptoms & Causes.

Endometrial Cancer Symptoms, In this video, Dr. Heena Chawla, a Consultant Gynecologist at Apollo Clinic and CHD city Hospital, Chandigarh talks about:

  • What is endometrial cancer? 
  • What are its signs and symptoms? 
  • How do we know if we need further screening for cancer? 
  • What are its different stages? 

WHAT IS ENDOMETRIAL CANCER? 

Endometrial cancer, as the name suggests cancer of the endometrium. The endometrium is the innermost layer of the uterus, the middle layer of the uterus is the myometrium, and the outermost layer is the serous layer. 

For any reason, if there is an uncontrolled growth of cells in the innermost layer of the uterus, then we say it is endometrial or uterine cancer. It is prevalent cancer in females. 

Earlier its prevalence was more in the western world, but now a days, its incidence has drastically increased in developing countries like India. Due to lifestyle modification, lack of physical activity, and excessive hormonal imbalance, the incidence of endometrial cancer is more in Indian females. 

First, we will talk about the risk factors associated with endometrial cancer.

WHICH PATIENT COMES UNDER THE RISK CATEGORY?

Among high-risk patients are those who have:

  • a high concentration of estrogen in their body for any reason
  • are obese
  • a Body Mass Index of more than 25 
  • are suffering from diabetes or hypertension
  • never been pregnant
  • any baby 

are maximum at risk of endometrial cancer. 

Apart from this, if you have a history of breast cancer or doctors have prescribed you medicines that have a direct effect on the uterus lining may put you at risk of uterine cancer. Patients with lynch cancer, in which there is a combination of colon and endometrial cancer, are also at a very high risk of endometrial cancer. 

Often patients ask in OPD how they would know or what test they should undergo. What kind of signs and symptoms do we observe?

WHAT ARE ITS SIGNS AND SYMPTOMS?

Endometrial Cancer Symptoms, Endometrial cancer, I would say, is one cancer in females that gives signs and symptoms of its onset in the form of uterine bleeding. We divide the menstrual cycle into three groups; In one group, we females are premenopausal with regular periods. Then we have the second group of perimenopause inclined towards the end of their periods, and the other group is at the menopause stage. The bleeding presentation in all three groups is different. 

Premenopause (Endometrial Cancer Symptoms)

In the premenopausal group with regular periods, if you have heavy bleeding, which usually doesn’t occur. Or may start bleeding again after periods stop, which we call inter-menstrual bleeding, these two critical presentations or signs that one must consult a doctor. 

Perimenopause 

Those in the perimenopausal stage are at the end of their periods; if suddenly there is a reduced frequency of periods according to their age, or they are having delayed periods or have minor bleeding may also be at risk. But if you have heavy bleeding or periods start coming fast, you must consult our doctor. 

Abnormal bleeding

There may be other reasons associated with heavy bleeding or early periods. We can’t always relate them to endometrial cancer, there might be some other reason related to it, but we must evaluate ourselves with the doctor. Many times we diagnose cancer in simple things. On average, ten may get diagnosed with endometrial cancer among a hundred women with abnormal bleeding. Under these circumstances, we must consult our doctor. If they advise biopsy, we should go for a biopsy. 

Post menopause group 

Next, we are coming to the postmenopausal group, where periods have stopped for almost one year. If these patients have bleeding or spotting, we must consult our doctor immediately. We must examine ourselves properly, and if they advise ultrasound, we should go for an ultrasound. And suppose we should opt for biopsy after considering ultrasound. In that case, the thickness of the endometrial lining, or some other reason if the doctor has advised you for biopsy, then we must go for a biopsy test. This was all about the bleeding patterns. 

Signs and symptoms 

Many patients who have endometrial cancer may suffer from stomach aches, which we call pelvic pain, or they may have a bloating session. Apart from this, they feel the change in their urinary habits like the frequent urge to urinate, or there may be changes in bowel habits like they may suffer from diarrhea or constipation. Apart from that, they have general signs like losing appetite and weight loss, which are some common signs of endometrial cancer.

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Bartholin Cyst Treatment | बार्थोलिन सिस्ट | योनि में गांठ के कारण व इलाज ? | What causes Bartholin Cyst?

Bartholin Cyst Treatment

Bartholin Cyst Treatment (बार्थोलिन सिस्ट का उपचार) 

Bartholin cyst treatment, In this video, SimpliHealth expert, Dr. Heena Chawla, Consultant Gynecologist at Apollo clinic and CHD City hospital Chandigarh, is talking about what is Bartholin Cyst (बार्थोलिन सिस्ट) and bartholin cyst symptoms, causes and treatments. 

First, we need to understand the meaning of the term Bartholin Cyst. Any water-filled clot is termed a cyst in medical language. 

WHAT IS BARTHOLIN CYST (बार्थोलिन सिस्ट)?

Bartholins are two pea-sized glands present at the vaginal opening. Their function is to maintain lubrication in the vagina. These glands release their secretion by their duct. 

Bartholin cyst treatment now, if there is a blockage in this duct, these secretions will not find their way out and will keep accumulating in the gland. Eventually, this would result in the formation of a cyst. This type of cyst is sized approximately from 1 to 10cm which means it may take the shape of a golf ball or lemon from a pea. 

WHAT ARE THE COMPLICATION ASSOCIATED WITH BARTHOLIN CYST?

Often patients come to the emergency with the indication of intense pain. The most important symptom of this cyst is severe pain in the cyst. Apart from pain patient may feel uncomfortable while rising, walking, or sitting. If there is an infection in the water-filled cyst, then pus formation is possible. Due to this, a patient may have a fever that may last longer. Often patients ask in OPD why these types of cysts occur.

WHAT IS THE PROBABLE CAUSE?

Usually, we see this type of cyst at 20-30 years of age. 

The reason may include:

  • Any injury or trauma
  • Some infections like Escherichia coli, Gonorrhea infection, or Chlamydial infection 

The patient often comes and asks whether stress is the reason for having Bartholin’s cyst. I would say no, stress doesn’t play any role in forming these cysts, but yes, it may lead to hormonal imbalance. But we can’t directly link it to the Bartholin cyst. 

Also, many times, patients ask if hormonal imbalance results in a Bartholin cyst? No, it’s not like that. 

Sexual Transmission 

Also, sometimes patients are in dilemma that Bartholin cyst is a sexually transmitted disease. No Bartholin cyst is not itself a sexually transmitted disease, but the causative bacteria like Chlamydia or Gonorrhea are sexually transmitted bacterial infections. But we can’t directly say that Bartholin cyst is sexually transmitted, then it’s not like that.

The second thing is that Bartholin cyst presents itself one side at a time. In a very rare case, we see its occurrence on both sides. Otherwise, it is seen on one side at a time.

HOW DO WE DIAGNOSE BARTHOLIN CYST?

Clinical examination performed by the doctor usually makes the diagnosis of this type of cyst. Depending upon the size of the cyst, symptoms, intensity of pain, and fever, a treatment plan is prepared. 

If you are above the age of 60 years, maybe the doctor would recommend a biopsy for a Bartholin cyst to rule out the possibility of cancerous growth. However, the occurrence of this type of cancer is less than 1 %. 

Sometimes this Bartholin cyst may rupture on its own. Small material oozes out as it enlarges and ruptures, including pus, bacteria, mucus, or blood. Often patients come with the symptoms of a ruptured cyst. 

WHAT ARE ITS TREATMENT PROCEDURES?

If we talk about its treatment, if the size of the cyst is very small, then we don’t require to do many things. Usually, the doctor advises the patients to have a Sitz bath at their house. The patient can take a Sitz bath by filling the tub with lukewarm water of approx 3-4 inches and sitting in it for 15-20 minutes. 

Apart from this, the doctor prescribes anti-inflammatory and painkillers to the patient to reduce the cyst symptoms. 

However, if it’s a large-sized cyst or pus formation or you are having intense pain, the doctor may advise you for surgery. In surgery, we do marsupialization these days. In this technique, we drain all the cyst contents and keep the cyst open so that secretions don’t get clogged, they come out, and the wound heals faster. 

But then also in 35-40% of cases, there is recurrent cyst formation, and the patient may require multiple siting of marsupialization. In this case, the doctor needs to remove the Bartholin gland, which is commonly called Bartholin gland excision. 

For this, the patients need to get hospitalized for one day at least. 

The procedure is performed under anesthesia, and technically it’s a little more complex than marsupialization. However, the procedure can be quickly done in patients with recurrent Bartholin cysts. 

HOW CAN WE PREVENT IT?

For its prevention, we must take care of vaginal hygiene and practice safe sex. If you have any issues, you may consult your doctor, get a diagnosis and start an early treatment under the supervision of the doctor.

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White Discharge Treatment | What is Reason of White Discharge In Female?

White discharge

White Discharge Treatment (वाइट डिस्चार्ज) In Female in Hindi | How can it be treated? 

White discharge treatment, In this video SimpliHealth expert gynecologist Dr. Heena Chawla, Consultant Gynecologist at Apollo Hospital and CHT City Hospital, Chandigarh, is talking about White discharge(वाइट डिस्चार्ज) in female in Hindi. 

All women face white-colored discharge at some point of time in their life. We treat white discharge many times, but it still keeps happening again. It can happen at any age. From young girls to pregnancy to menopause. The problem of this white discharge continues. Today we will discuss: 

  • Why does this happens? 
  • What are the types of white discharge? 
  • When do we need treatment and when our partner needs treatment? 

Understanding why white discharge happens

First, we must understand that white discharge can be a physiological means. What happens here?.

When ova are released from the ovum or follicle during the ovulation process, it is usually accompanied by transparent and sticky white discharge during a mid-cycle. So again, every woman goes through this phase, but the amount may differ for every woman.

It can be as little as a tablespoon. And if you don’t have a foul smell in the discharge. There is no stain on your inner clothes, no itching; this discharge is normal. We do not need any treatment, and as soon as the time of menstruation comes after ovulation, it may cause a little trouble. Its consistency changes. And then it becomes normal after menstruation. 

We talked about the normal discharge; if this discharge is smelling or changing its color, then we need to treat it. So for foul discharge, we should consult our gynecologist and do a health test. 

Risk factors of white discharge in female 

Patients often come to our OPD and say they get a very thick white discharge.

Commonly called  yeast infection, candidiasis, or fungal infection. The thick discharge is often more in the women who have diabetes or who are taking 21 days of pills, or who have taken many antibiotics. Lack of immunity or are immunocompromised in patients causes thick discharge due to yeast infection or candidiasis. 

Treatment of white discharge in female

For its treatment, we give simple antibiotics or antifungal medicine, by which white discharge problem resolves on its own. In many cases,  the color of this discharge becomes greenish or yellowish. There can be many reasons behind its color, such as infection of Trichomonas and Gonorrhea illness. The color of this discharge keeps changing under these illnesses. 

Causes of white discharge in female

Now, the patient often asks in the OPD why does white discharge happen?

The first reason is hygiene, which we always forget. Then there is some sexually transmitted disease or improper menstrual hygiene. So if you have a yellow or green discharge, we need to take antibiotics for it. Now there is another type of discharge that happens before or after menstruation. It often occurs when bleeding occurs after menstruation; then, it does not occur in the middle, there are some spots, and it is normal. So we don’t need to do anything about that. 

However, in some cases, there is spotting or discharge after periods. Let’s say you have a five-day cycle and have bleeding for five days, and then it stops, then again on day eight to nine, you have spots; this is called intermenstrual bleeding. We need to seek our doctor for intrauterine bleeding and get the proper treatment. There can be injury or could be polyps lying in the uterus. So there can be many reasons for the occurrence of intrauterine bleeding. But for this, we must get ourselves examined by the doctor.

What can we do from our side to minimize the discharge? 

Personal hygiene (White Discharge Treatment)

Whatever quantity of white discharge we have or it is repeatedly happening. First of all, I would say that we have to take care of some simple healthy measures. We don’t have to clean it with soap or water on every visit to the washroom. No, not at all, but we have to keep our private parts dry. Whether we use cotton for this or we have to keep it dry for some time. 

Vaginal hygiene 

Apart from this, whenever we clean it, we have to clean it from front to back, not from back to front, because by doing this, we are bringing the bacteria of our anal area into the vaginal area. This type of cleaning may cause bacterial infection in the vagina. So we always have to clean from front to back. 

Apart from this, we must increase the number of green vegetables and fruits in our diet. It gives us immunity, and we must also eat curd. It contains some good bacteria, which helps us to eliminate the discharge.

Apart from this, we have to take special care of menstrual hygiene; often, patients complain about an increase in discharge after menstruation. With time, it gets worse. So for this, I would like to say that we have to change sanitary pads after every 4 to 6 hours, and many patients spend the whole day in one sanitary pads, but this does not seem right. So we have to take special care of cleanliness. 

I would say that we should not use douches or any fragrance without asking our doctor. Apart from this, we need to intake ample water in our diet. Whether we are drinking juice or coconut or ordinary water, we have to keep an adequate quantity of Lassi, chach in our diet. Those who have diabetes should keep their sugar under control because due to uncontrolled sugar, white discharge increases significantly. 

Urinary tract infections may also increase the white release Plus we should not eat antibiotics unnecessarily. Taking antibiotics unnecessarily may alter the vaginal flora. Use antibiotics only when prescribed by the doctor… I am sure that if we use all these things, it will help reduce the frequent vaginal discharge. 

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Labor Pains Symptoms | Delivery Pain Symptoms | When to go to the Hospital?

Labor Pains Symptoms

Labor Pains Symptoms and its signs. When to go to the hospital? (हिंदी में जानकारी)

Labor Pains Symptoms, In this video SimpliHealth expert Gynecologist Dr. Heena Chawla is talking about labor pains, signs of labor pain and she is also answering questions like:

  • How are the labor pains? 
  • What is the right time to visit the doctor? 
  • When should I get ready for hospital admission? 

This video is dedicated to the patients who live in nuclear families and don’t have an elder to explain these things to them. Often, patients ask a general question in OPD: when is the right time for the hospital admission?

What are labor pains? When you feel the right labor pain?

Labor Pains Symptoms, You should rush to the hospital. We often think of minor aches during the last month of pregnancy. We call these regular Braxton Hick contractions. People often confuse false pain with labor pain. But when we have labor pains, we have to understand that it hurts very badly. During labor pains, minor aches occur frequently and with increased intensity. Like earlier, the pain was coming every 10 minutes, which lasted for 10-15 seconds, but during labor pain, this pain gradually intensified; as if earlier it was coming every 10 to 15 minutes, now they are coming every 5 minutes. They will start coming in minutes, and the duration of pain increases from 10 to 20 seconds to  20 to 30 seconds. They will start coming more quickly. 

Like we say that every 5 minutes, you will begin to have pain. And at the same time, their duration becomes worse, with pain lasting for 30 to 40 seconds. And these pains do not go away from doing anything. In this, the woman cannot do her daily work, and changing any position does not help ease the pain. Instead, their duration and intensity increase, then we should understand that this is actual true labor pain. And at this time, we need to rush to the hospital for admission. 

The second thing is that whenever we talk about delivery, I always explain the following  four things to my patients, 

  1. You will start feeling labor pain.
  2. You may burst your water bag or leak water (your water would break).
  3. The third thing is a decrease in fetal movement or reduced baby activity.
  4. And the last thing is bleeding. 

If you see any of these symptoms, you must contact your doctor. 

When should you go to the hospital? 

Now we have discussed labor pains and what is the right time for the hospital admission. 90-95% of the patients have labor pain before delivery. However, in only 5 to 10 cases, the leakage of water commonly called a burst of water, occurs, followed by labor pains. Patients often get confused when there is too much leaking. Whenever there is a leak or rupture in the bag, a transparent liquid like urine oozes out. But even in the last month of pregnancy, patients may have the condition of frequent urination.

Also, the baby puts pressure on the bladder, causing a slight leakage of urine. So patients get confused to a great extent, whether it is urine or leakage of the sac. See, there will be a kind of smell in the urine, and its quantity will also be less, and if you go to the washroom, it will reduce the leakage. But, when the bag bursts, we get so much flow that the clothes get wet. And it goes on continuously, and it doesn’t stop even after urinating.

The third thing is what we call, decrease in the baby’s activity in the last three months of pregnancy. The doctor recommends keeping track of fetal movements especially in the last two months. If the fetal movements are more than ten, they are entirely normal. But anytime you feel that the baby’s activity is decreasing, you should visit your gynecologist. 

Sometimes we think less movement, but everything seems fine when your doctor checks with an ultrasound. Sometimes the child must be in their sleep cycle, or the mother has not taken a proper diet. So these two things may lead to reduced fetal activity. But sometimes, it can also signify that the child is under stress. So sometimes the baby is facing some problem, or if the water around the baby has become less, this may also reduce fetal movement. Whenever something like this happens, you must immediately consult your gynecologist. 

The fourth thing is the occurrence of bleeding. During the last trimester of the pregnancy, the labor pain onsets, and the release of cervical mucus plug leads to a bloodstain. So because one doesn’t have proper bleeding, there is a little bit of blood stained discharge. If anything like this happens, then I would say that you go and meet your doctor immediately. We have understood our signs of having pain, leakage of water, lack of activity, or any bleeding. 

According to the doctor’s opinion, you should directly go to your doctor and prepare yourself for the hospital admission.

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Uterus Removal Surgery | गर्भाशय हटाने की सर्जरी | कारण और यह क्यों जरूरी है ?

Uterus Removal Surgery

Uterus Removal Surgery (गर्भाशय हटाने की सर्जरी) reasons & Why it’s necessary

Uterus removal surgery, In this video SimpliHealth expert Gynecologist Dr. Heena Chawla is talking about Uterus Removal Surgery reasons and also she is answering some common questions that people usually ask like:

  • Is it necessary to remove the uterus? 
  • What is the possible reason for uterus removal? 
  • How will I know when I need an operation and when not? 

Uterus removal means removal of the uterus by surgery. Hysterectomy has become a general surgery and is the second most common surgery after the cesarian. 

What conditions do we need to remove the uterus? 

Uterus removal surgery is our last resort. When we are not benefiting from medicine or any other procedure, I would say that we give this surgery of uterus removal option to the patient. Patients often come to OPD and complain that they have been discharging very fluently, so please remove the uterus or have children; our family is complete, so remove the uterus so that we don’t face any further problems. We don’t think the same about the rest of our body parts, their lungs. 

  • Do we remove them, or we have intestines? 
  • Shall we remove them too? 
  • So why do we think the same about the uterus? 

CANCER | Uterus Removal Surgery

The first reason is cancer. If you have uterus cancer, cervix cancer, or cancer in ovaries or fallopian tubes, there is seriously a need to remove the uterus. It is an extensive surgery and takes time because we need to do it in detail. 

FIBROID

Apart from this, the following most common reason for uterus removal is fibroids.  We need to understand this thing about fibroids. Some fibroids are very small in size l, and they are not cause any problem, so we don’t need to remove the uterus in these cases. However, sometimes these fibroids increase in size and may reach up to 15-16cms, or they may grow up to 8-10 cm in size. So in the case of a large fibroid, we need to remove the uterus. Though fibroids are often small, the patients are bleeding a lot. They visit us frequently with 2-3gm of hemoglobin, and even after giving medicine and hormone-related medicine. If their symptoms are not improving; there is a frequent drop in hemoglobin.Under these cases, the doctor advises surgeries. So that after surgery, you can remove the uterus. 

ADENOMYOSIS

There is another prevalent condition which is called adenomyosis. In this, as the period comes, the bleeding is getting collected somewhere in the muscle layer of the uterus. In everyday language, we say this to the patient: there is swelling in the uterus. Since the bleeding doesn’t find any outlet increasing the size of the uterus, periods start coming early from the times there is heavy bleeding. And one may feel a lot of pain during the duration of periods as much as they can’t do their household routine work. So when there is a condition like this, when we have tried medicines and hormone coated copper-T, but still the patients feels no relief, then we advise uterus removal or hysterectomy to the patient.

ENDOMETRIOSIS

Another common condition is endometriosis, where the innermost layer of the uterus, the endometrium, starts growing in different parts of the stomach. So when these lining is growing, they stick to each other, causing pain. We have good medicine, but few patients don’t react to it. So we advise them for surgery. Finally, there is a need for uterus removal under a 3rd degree UV prolapse, in which the uterus slides down. 

3 RD DEGREE UV PROLAPSE  | Uterus Removal Surgery

There is another condition where the innermost layer of the uterus, is endometrium, gets thick, called endometrial hyperplasia. In cases where the condition is going towards a pre-cancer stage, they also need to remove the uterus surgically. Suppose there is some change taking it to the precancerous stage called atypia. In this case, the doctor chooses to remove the uterus or follow any hormonal treatment how do you want to stratify the risk. So in these cases also, we advise uterus removal. Usually, in minor conditions like endometrial polyps, if we have any discharge or there is some infection of the cervix, in these cases, we don’t advise removing the uterus.  And even if we have to remove it, there are all types of treatment available, even for cancer. We operate with a telescope  in which patients recover faster and are better cosmetically.

Thank you 

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Hysterectomy Side Effects | गर्भाशय सर्जरी के बाद सावधानियां | Precautions After Uterus Removal

Hysterectomy Side Effects

Hysterectomy Side Effects, (Hysterectomy) What happens after surgery for uterus removal?

Hysterectomy side effects, There are a lot of queries regarding the precaution one must take after surgery for uterus removal. In this video, SimpliHealth expert Gynecologist Dr. Heena Chawla is talking about Hysterectomy: surgery for uterus removal) and also, she is answering some very common questions that people usually ask, like:

Precaution after uterus removal 

Uterus removal is the second most common surgery after a caesarean.

Tips to follow after the surgery of removing uterus

The patient must first remember to understand their medical regime very carefully after discharge from the hospital. And we must follow the medicines as told by the doctor. 

Medication after uterus removal surgery

Hysterectomy side effects Usually, doctors prescribe an antibiotic to prevent any infection; and pain killers since they are in a lot of pain. But one must understand carefully at what time they should take the medicines.

What other condition may a patient experience?

If the patient feels constipation, doctors may give them a laxative to ease the bowel movements.

Why is hydration after surgery necessary?

After the discharge, one must remember to hydrate themselves by having water after coming home. It helps us in 2 or 3 ways, like reducing the possibility of urinary tract infection. And it would prevent urine infection since doctors use a catheter to drain urine. And the second thing is one feels not have constipation. Since the consumption of antibiotics, improper food intake, and restriction in physical movements may increase the risk of constipation.

Other things to keep in the loop are:

The patient must have a good quantity of green leafy vegetables and fruits in her diet. 

 How much rest do the patients need? 

The definition of rest depends on what type of surgery the patient had. Usually, nowadays, doctors perform these surgeries by laparoscopy. So it doesn’t need many days of rest, but you would need more time to heal if you have had open stomach surgery and have stitches. So we recommend having some rest in it. 

Can the patient walk? (Hysterectomy Side Effects)

Some light walking routines at home and little exercise help uplift the mood. It reduces the risk of blood clotting in veins, often called deep vein thrombosis. Apart from this, a fundamental question patients ask is:

Can the patient climb stairs after a Hysterectomy? (Hysterectomy side effects)

You can easily take the stairs at home. Initially, you may feel that you are taking the slope, but everything will be regular with the recovery. A similar thing is with walking. Initially, we need to start walking for 5-10 minutes, and as we start increasing the time of strolling after six weeks, we can walk as per our usual routine of 30 minutes. Another essential thing we need to keep in mind after a hysterectomy is that we should not lift heavy objects for at least one-half months or six weeks.

Physical relationship after surgery? (Hysterectomy Side Effects)

One needs to abstain from any physical relationship. For example, after removing stitches, one must take calcium supplements because during Hysterectomy, whether they have kept the ovaries inside or removed, there is a decrease in the estrogen level.There are not many depositions in bones, so we must take calcium supplements. 

Bottom line

Apart from that, I would like to give small tips that when you plan this surgery, you must arrange some help beforehand like for the kitchen or your care after surgery. So that later you will not have unnecessary stress about all these things. So we need to take care of these things after surgery.

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Amniotic Fluid Index | Normal Range (एमनियोटिक द्रव) | What Would Happen If the Fluid Is Less?

Amniotic fluid Dr. Heena

Amniotic Fluid Index (एमनियोटिक द्रव): What would happen if the fluid is less?

Amniotic fluid index, In this video SimpliHealth expert gynecologists Dr. Heena Chawla is talking about Amniotic fluid(एमनियोटिक द्रव) and also she is answering very common questions that people ask like:

  • How important is the amniotic fluid surrounding the baby’s during pregnancy? 
  • What would happen if the fluid is less?

Watery substance surrounding the baby (Amniotic Fluid Index)

The amniotic fluid surrounds the baby inside the sac; this fluid helps in the baby’s growth, movement, and bone development. For example, when a baby moves their finger, it doesn’t stick to each other. Instead, they slide so that they don’t stick together..  Because of this, amniotic fluid is essential for the baby’s development.  This fluid plays a vital role in developing the baby’s lungs, it builds immunity and umbilical cord of the baby doest doesn’t get pressed. 

Apart from this, the fluid acts as a shock absorber for the baby, which means if the mother gets some shock, it does not transmit to the baby. So like a shock absorber, it protects the baby from the outside environment. The baby drinks this fluid and passes urine in the same. So it helps in developing the digestive system of the baby. In general, you must have seen that experts mention the ‘amniotic fluid index’ in ultrasound. Experts simply measure the amniotic fluid, and if it is less than 5 cm, or experts merely measure one pocket of this fluid if it is less than 2 cm experts can deduce that the fluid around the baby is also less. What can be the problems if the fluid around the baby is less. 

The baby’s movements are restricted, the baby may develop contractures, it also affects the lung maturation of the baby. The baby doesn’t find enough space to move around in a few cases. In addition, the baby may have fecal distress, and in many rare cases, if the fluid runs out entirely, it may lead to stillbirth or death inside the womb. So many patients come in the OPD and ask 

Why does this fluid get reduced after all? 

There are two reasons for low fluid: 

  1. One is there are reasons related to the mother
  2. The second is related to the baby

Reasons related to mother include blood pressure issues or some have twins or triplet or multiple pregnancies. In these cases also the amount of fluid is reduced.

In many cases, if the pregnancy is going beyond maturity, commonly called post maturity, the amount of fluid decreases. Another reason that is baby-related includes the baby having any chromosomal disability or a genetic problem. Hence, the concentration of liquid drops. Otherwise, if there is a kidney-related problem like the kidney is underdeveloped or there is the formation of a cyst. etc, Hence, all these reasons contribute to reduced fluid in the sac. And sometimes, if there is a problem in all placenta, it leads to a gradual decrease in the sac fluid. 

What do we do now?. What should we do if the water gets low and the ultrasound shows less water?

The first foremost is to increase water intake, especially fluids, like coconut water. Experts especially ask to have coconut water because it is high in potassium, so we must include this in our diet. Other things are lassi or chanchor juices or soup. We must increase our water intake by 3-4 liters, which means one must have at least 12-15 glasses of water. The second thing is one must have a high protein diet; the more diet is good, the more chances of an increase in the fluid. Apart from this, we must include exercise in our diet. The more we exercise, the more the circulation around.

Some doctors may advise some supplements. These supplements help in increasing the fluid around the baby or remain so. The other most important thing is that experts ask the patient to rest and sleep on their left position as much as possible.   One should  add fruits to our diet like watery fruits like strawberries and grapes, which helps increase the concentration of fluid. By taking all these things, the fluid remains around the baby. 

Our efforts are to maintain the amount of fluid around the baby until 36 -37 weeks of gestation. But in many conditions, the amount of fluid starts reducing before time. So in these cases, we need to go for pre-term delivery. Usually, if the fluid is exhausted entirely or there is a minimal amount of fluid left, we need to opt for cesarian deliveries.

Because the amount of fluid the baby has to slide down or according to which the baby can slide down easily is not enough, in such a situation, we have to go for cesarian section delivery. So our experts would like to advise you that please get your ultrasound done from time to time and follow the doctor’s guidelines. In some cases, fluid supplements, in addition to medicines, may need to be given intravenous fluids to increase the amount of fluid in the sac. you must follow your doctor’s advice and take care of yourself during pregnancy.

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6 Month of Pregnancy | Baby Development Stages | Symptoms | गर्भावस्था के 6 महीने बच्चे का विकास

6 Month of Pregnancy | Baby Development Stages | Symptoms | गर्भावस्था के 6 महीने बच्चे का विकास

6 Month of Pregnancy |गर्भावस्था के 6 महीने

6 Month of Pregnancy, In this video SimpliHealth expert gynaecologist Dr. Heena Chawla is talking about Baby development during 6 month of pregnancy. Also she is answering some very common questions that people ask like:

  • What kind of blood test should you take during the first six months of pregnancy?
  • 6th Month Of Pregnancy Diet 
  • What are the changes a mother undergoes during this time?

What things should you take care of and what kind of blood test should you take during the first six months of pregnancy? |6 Month of Pregnancy

First of all, let’s talk about baby development. During the six months of pregnancy, the baby’s weight varies between 700 to 900 grams. If you have seen it carefully in the scan done in the 5th month, i.e., the anomaly scan/level 2 Ultrasound, the baby’s weight is recorded as either 300 or 500 grams, not more than that. But at this time, the baby’s weight starts increasing. The baby’s size at this time is approximately 7 to 12 inches. Apart from this, 

See, at this period, the baby’s skin is reddish. There is no development of melanin pigment in the baby. So by next month, the baby will reflect our skin texture because such cells develop inside the baby, reflecting our skin texture. Uptill now the baby’s skin would be reddish in color. Apart from this, at this time, the baby’s lungs are fully grown, but yes, they are not mature. The maturity of the lungs, which means that the baby can inhale on its own after coming out, happens after approximately 34 weeks. But at this time, the lungs are fully grown to their size. One more crucial development that occurs during this period in babies is the baby’s eyes, which means there is a development of eyebrows and eyelashes. There is the initiation of baby’s eye movements; even beneath closed eyelids, some babies may start slowly opening their eyes. 

Even babies can open their eyes by this time. Another significant development in the baby is the development of easily visible fingerprints. You can make a baby listen to any kind of music. The baby’s ability to understand the external sound has come by this time. To this, experts talked about what developments happen inside the baby.

What are the changes that the mother feels during this time?|6 Month of Pregnancy

First, nausea and vomiting would have settled to a great extent by this time. It is very natural when nausea and vomiting stop, they start feeling hungry. So the hunger levels increase to an extent. Apart from that, a baby bump is visible. If your baby bump is not visible until now, it will undoubtedly show by this time. Up to Umbilicus, if you lay your hands on the abdomen, you can see the baby bump till the umbilical cord.  Swollen feet or pedal edema is common in patients. 

Some may have difficulty breathing because as the uterus gets bigger, it compresses the diaphragm in the stomach. So shortness of breath is very common among females during this time. A very common thing which one feels till six months is that leg cramps start happening very frequently. Because as the baby grows and the mother is also gaining weight, the feeling like cramps starts coming due to the weight factor. There is an increase in the frequency of urination. As the uterus grows in size, it compresses the urinary bladder. One may tend to pass urine all the time. So these are some changes that start reflecting in a mother by this time. Sometimes your belly button starts coming outwards. so all these changes are normal during pregnancy. Now our experts will talk about 

What tests should you do for six months? 

There are two significant tests one must undergo by this time. First is the CBC test, in which experts determine the concentration of hemoglobin which is very important, and the second test is the glucose intolerance test. Experts take fasting samples in the morning; you are given glucose after that. Then after 1 hour and two hours, a blood sample is retaken. So in this, we see that the mother is not showing any symptoms of pregnancy-induced diabetes. So for this, it is essential to get a GTT test. So these two are very important to test during this time. A very important thing that everyone asks us 

What you should change is the diet?

You must include plenty of fluids in the diet; you can take anything, whether you consume water or coconut water, juice or lassi. There are many benefits from this. You do not contract urinary tract infections, do not get constipated, and most importantly, the water around the baby remains maintained. So that’s why you have to keep the fluid intake very good. And you must have green vegetables and fruits as they contain omega fatty acids and provide antioxidants that help in the baby’s growth. So these two very important changes you have to include in our diet in six months of pregnancy. Six months of pregnancy is the ideal time to travel either to your maternal house or meaningful work. 

You can easily travel and be back. You can plan your baby shower during this time of pregnancy. You should start thinking about our doctor and hospital; because many times it happens that the pre-term pain will begin in the 7th month. So if you have already decided on the hospital or have finalised the doctor, then you will go ahead by planning so that you won’t need an emergency or panic in the end. So enjoy your pregnancy, and if you have any further questions, do post in the comment box. Thank you

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Planning for Pregnancy | Pregnancy Diet Plan | Advice & Tips | गर्भावस्था की योजना | गर्भावस्था आहार सलाह और सुझाव

Planning Pregnancy

Planning for Pregnancy  Experts Advice & Tips for Pre Pregnancy Planning

Planning for pregnancy, In this video SimpliHealth expert gynecologist Dr. Heena Chawla is talking about planning pregnancy and its  tips or प्रेग्नन्सी प्लॅनिंग करना क्यों जरुरी है?. Also, she is answering some important questions that people ask in OPD like:

  • Why is there the importance of the fertile period? 
  • What can be done to know the time of ovulation? 

This video is specially dedicated to couples planning pregnancy and other natural methods one can do for natural conception. First of all, I would like to tell you that for all the couples planning pregnancy, especially if the female partner is less than 30 years of age. 

The couple should at least try for one year.. If it doesn’t happen in that span, you visit your doctor for help. Or if your age is more than 30 years, then we will say that you should try at least for 6 months.And if you are trying for pregnancy. But still it is a pregnancy failure, you should go to the doctor and seek help. 

The most important thing one should know: what is their fertile period, or what is the fertile window

(Planning for Pregnancy) What is the fertile period?. What is a fertile window?

Before this, one should know about their cycle. Now suppose you got your period on the 1st and the next period was on the 30th. Then the length of the cycle becomes 30 days. If the length of your cycle is 30 days then the fertile period is almost near the 16th day. If we calculate the cycle length, suppose it is of 28 days, then your fertile period will be around 14th day. Fertile period is when an egg or egg follicle is ruptured from the ovary and released. 

Why is there the importance of the fertile period? 

Because the ova lifespan is only 12-24 hours. So if sperm did not fuse with the ova at that  time interval, then there are fewer chances of pregnancy.  Often, couples come and say that they are trying for a longer duration for pregnancy. But if we are not trying in a proper fertile period, this won’t lead to pregnancy. Many times couples say they were trying but it didn’t happen, so we visited the doctor. We conceived in the first cycle. Because the doctor manages things according to the fertile period for a positive pregnancy.That is, it is essential to consider the fertile life of an ova is only for 12-24 hours, whereas the lifespan of sperm is five days. So if you make a relationship during the fertile period only, the chances of pregnancy are maximum. 

What can be done to know the time of ovulation? 

Our body gives us different signs that we should notice. Like, some females have lower abdominal pain on one side, some may have very thin vaginal discharge, some may feel tenderness in the breast, some may feel a rise in basal body temperature. We could understand that it’s the time of ovulation through all this. Apart from this, many ovulation kits are available in the market. LH, i.e, Luteinising hormone surge/ increase before ovulation so these kits can detect it. So that we get the idea that it’s about the time of ovulation. Apart from this, we do some follicular study. We do the serial number of ultrasounds to understand how the follicular size increases during a cycle.  And accordingly, the estimated time of ovulation is determined. So accordingly, we timed the relationship. 

The second most important thing that many patients ask in OPD is: 

What should we eat during this period?

We should eat green vegetables and salad. They are essential to our diet because they have antioxidants and omega-3-fatty acids, especially in nuts. It improves the quality of the sperm and ova both. The doctor asks to avoid only two things: papaya and pineapple. Any couple who is planning a pregnancy should avoid these two things. 

Apart from this, one more important thing is maintaining a healthy lifestyle. Must do exercise for at least 30 minutes a day. One may do brisk walking, but 30 minutes daily is essential. It gives us two benefits: first, the women who are overweight and are planning for pregnancy will help them lose weight, and secondly, release stress-relieving hormones. Another vital thing doctors observe is the pattern that patients when they come to OPD, is that they don’t have time. 

Their work schedule is like some have a night shift or someone is on night calls, and they don’t get time. But see if you want to plan pregnancy; we need to reduce our stress levels and modify the lifestyle a little bit. This is not like an exam. Sometimes couples say they will be pregnant in the coming September. This is not the kind of exam. So as much as we reduce the stress levels, our hormonal imbalance will automatically get corrected. 

Apart from this, there are some prenatal supplements for couples planning pregnancy; out of them, folic acid is essential. We start early so that the baby doesn’t have any congenital malfunction. In addition, we perform blood tests to check for any vitamin B12,or vitamin D deficiency, because this also relates to infertility. Some simple blood tests are performed, like thyroid. Sometimes due to thyroid also there is a miscarriage or unable to plan pregnancy. 

So by very simple medicines and with hormone replacement, pregnancy is possible at an early stage. One should avoid consuming alcohol and smoking. Because it affects the quality of both sperm and egg. If we keep all these small things in mind, we can plan the time conception early and timely. Thank you.

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Bulky Uterus | Adenomyosis (एडिनोमायोसिस : भारी गर्भाशय) What complications it causes?

Bulky Uterus Treatment

Bulky Uterus Treatment (Adenomyosis) भारी गर्भाशय: complications it causes?

Bulky uterus treatment, In this video SimpliHealth expert gynecologist  Dr. Heena Chawla is talking about Bulky Uterus(Adenomyosis) or भारी गर्भाशय. Also she is answering some important questions that people usually ask their gynecologist like:

  • My Ultrasound has reported a bulky uterus. Do I have to remove the uterus for this, or will I conceive with this report?

What is Bulky Uterus(Adenomyosis)? | Bulky Uterus Treatment

Bulky, as experts know, is bigger than the standard size. The normal size of the uterus is 6.5 *  4*3 cms, so bulky is if it is more than that, technically, if the uterus size is more than 8 cm, it is a bulky uterus. 

Often our experts have noticed in the ultrasound that it is written in bold letters that I have a bulky uterus, many times, my friends call me and ask if it’s a bulky uterus in ultrasound. Do I have to do anything ? Do I need treatment for that?

Bulky Uterus Causes

You have to understand the reason behind the bulky uterus is the previous pregnancy. If you have any last pregnancy, during pregnancy, the uterus size increases to 35-36 cm, and slowly it shrinks to its standard size. Generally a gap of 0.5-1 cm is observed during shrinkage, so in that case 7.5  is normal and there is nothing to worry about as long as there is no heavy bleeding, or backache.

Bulky Uterus with Thickened Endometrium | Bulky Uterus Treatment

Apart from this, one thing more important in the bulky uterus is the layers of the uterus. One is the innermost layer called the Endometrium. The other one is the muscle layer that is the 

myometrium, if there is an increase in the thickness in the innermost layer of the uterus due to some reason that also comes in the bulky uterus. And if there is an increase in thickness in the muscle layer in the myometrium for some reason, that is also considered the bulky uterus. 

The most important reason for the thickness of the myometrium is the presence of fibroids. Fibroids are known as rasouli in the everyday language. Suppose these are present in the innermost layer of the uterus inside the endometrium. 

In that case, that will prevent pregnancy which may result in heavy bleeding or prolonged bleeding, one may have back pain, and the duration of periods may increase. So if any couple who are planning pregnancy, fibroids are present in the innermost layer, the endometrium, also known as submucosal fibroids. It is necessary to remove them. Suppose they are present in the muscle layer called intramural fibroids,their impact will  depend upon the size and the location of the fibroids. 

If they are not pressing the innermost layer of the uterus, they will not affect the natural conception process. Still, sometimes few fibroids increase in size, and they start pushing the innermost layer. So there are some changes in the internal environment of the uterus because of the large size of fibroids. It may bring problems in natural conception, and even if you have naturally conceived, it may lead to abortion. So, our experts need to remove them, which could be done by laparoscopy. Another reason is adenomyosis. 

What happens in adenomyosis? 

The menstrual blood starts accumulating in the muscle layer of the uterus, and it doesn’t find an outlet. So after every cycle, when it starts getting in the muscle layer eventually results in the large size of the uterus, called a bulky uterus. 

Apart from this, if I would say the couples planning pregnancy, the presence of bulky uterus or swelling in the uterus is one of the main reasons for being unable to conceive naturally. Among them, tuberculosis is the most crucial cause or occurrence of any other type of infection that may affect the process of natural conception. 

For those patients who have tuberculosis, it has been seen that around 40% of couples, tuberculosis is a significant factor in India in preventing conception. Most commonly, these tubes are affected, and in up to 50% of cases due to tuberculosis infection, the tubes are damaged, thereby affecting the conception process.

Apart from this, the innermost layer of the uterus, due to the tuberculosis infection, i.e., the innermost layer of the uterus, that is, the endometrium, starts sticking to each other. Due to this, there is a formation of adhesion. The pattern is that the number of days of the periods start increasing, and as the endometrium layer gets stuck to each other, in some cases, the periods start decreasing. Some patients may have amenorrhea, i.e., periods stop abruptly. In addition to tuberculosis, it gives other signs you may have weight loss, loss of appetite, and some may have a low-grade fever. 

Diagnose Tuberculosis

There are many simple tests to diagnose tuberculosis, and it can be treated very easily. Apart from this, there are more chronic pelvic infections, for example, PID, due to which the size of the uterus gets bulky. Until the bulky uterus doesn’t give symptoms, we shouldn’t fear by analyzing the ultrasound report. 

If we have heavy bleeding or have back pain, or our periods are coming early, we should consult a gynecologist and get this treatment for the bulky uterus. And yes, if you are planning pregnancy and have been diagnosed with a bulky uterus in the ultrasound, you should meet your doctor and consult with her about whether we need any treatment.

In many cases, it happens that it is an incidental find. Experts go for an ultrasound, and are diagnosed with fibroids or a bulky uterus. So in many cases, experts continue the pregnancy by prescribing mild medicines, and experts can continue with the pregnancy. So one should meet the doctor and find out whatever treatment is possible and discuss it.

Thank you.

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Cervix Stenosis (सर्विक्स स्टेनोसिस): Can closed cervix cause infertility (क्या बंद गर्भाशय ग्रीवा बांझपन का कारण बन सकता है?)

Cervix Stenosis

Cervix Stenosis (सर्विक्स स्टेनोसिस) Can closed cervix cause infertility? 

Cervix stenosis, In this video SimpliHealth expert gynaecologist Dr. Heena Chawla from Apollo Clinic Chandigarh is talking about infertile couples where a closed cervix  is considered a fundamental reason for this issue.

Cervix Stenosis

Cervix is the Mouth of the uterus. The mouth of the uterus is very much significant for pregnancy. Approximately according to our experts, 10% of cervical factors contribute to pregnancy failure. Cervix is considered a gateway. Cervix acts as a gate to ascend the sperms into the uterus. What happens during ovulation meaning when the egg is released from the ovary before that, the cervical mucus gets very thin because of estrogen actions and release of estrogenic hormones in large amounts, which leads to thinning of mucus which allows the sperms to ascend quickly inside the uterus. 

After post ovulation  i.e after ovulation, the estrogen level goes down, and the progesterone goes up, due to which mucus gets thick, failing in ascending of the sperms. So the cervix is very important because sperms get a proper way to ascend upwards. The eggs are released from the ovary, and the sperms reach the eggs. 

They both get fused and fertilised in the fallopian tubes completing the fertilisation process. Cervical stenosis, or if the mouth of the cervix is closed very tightly, then sperm don’t find a way to go upwards. 

What condition can this happen? 

The first and foremost condition is that one has undergone any D & C, which is termed cleaning in everyday language. If there has been a Dilatation and Curettage, in these cases, the cervix is closed very tightly, or one has undergone cervix biopsy, especially Cone biopsy. In this, biopsies are performed in those cases where there is an abnormal Pap smear. If any abnormality is seen in Pap smear, we do a cervical biopsy, or cone biopsy is needed. The second most important reason for closed cervix is infections. 

There are some chronic infections due to which the cervix’s mucus gets damaged. Hence sperms don’t get a favourable environment to move upwards. In a few cases, anti-sperm antibodies are produced, which work against the sperms. So if these are produced again, sperm doesn’t get the space. 

Lastly, if you may have a genetic abnormality, they have a closed cervix or tightly closed stenosis, cervix occurs. For its diagnosis, the doctor takes a complete history of the patient. Apart from this one examination in simple language, the internal examination by a gynaecologist is very important Third, one ultrasound is done through which we know the cervix parameters. if we say that there is an infection or have taken any old biopsy. Hence, we try to treat them in these cases by prescribing antibiotics. 

Few medications are given for anti-sperm antibodies to make the cervix environment favourable. And suppose if we are not getting help from any medication, we use assisted reproductive techniques, which is IUI, in which we directly insert the sperms into the endometrial uterine cavity bypassing the cervix entirely. So if you are suffering from any of these problems, you must meet your gynaecologist, get your examination done, and discuss your treatment options.

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Heavy Menstrual Bleeding | Menorrhagia (मेनोरेजिया) | Heavy Periods | भारी एवं असामान्य मासिक धर्म रक्तस्राव

Menorrhagia(heavy menstrual bleeding)

Menorrhagia (Heavy Menstrual Bleeding) 

In this video, our expert gynecologist Dr. Heena Chawla is talking about Menorrhagia or heavy menstrual bleeding. 

Heavy bleeding period

One more question that is generally put up to us  in the  OPD is regarding women having periods for a prolonged period. Females have periods  for almost one and a half to two months continuously. Some have heavy bleeding, and in a few, bleeding stops for 2-3 days and then starts again. So this is called heavy menstrual bleeding or menorrhagia.

One should never ignore this menorrhagia and one must visit their gynecologist. One needs to get some tests done so that the doctor can identify the reason behind this irregularity in menstrual patterns.

Menorrhagia problems/risk factors

There may be a  problem of hormonal imbalance or a thyroid problem, or it’s the fibroids due to which there is heavy bleeding. And it could be adenomyosis or endometrial hyperplasia in which the innermost layer of the uterus, the endometrium, gets very thick.

So there are different reasons due to which they have heavy bleeding for a longer period of  time. In this, some basic blood tests and hormone tests are performed to determine the reason. It is self-evident that if one has heavy bleeding, the woman might lose blood, which will affect the quality of life. One may have a feeling of tiredness and anemia during periods. Doing even a little amount of work  can lead to shortness of breath, which are all  signs of anemia . So if any female is suffering from this problem, she must consult a doctor.

Thank you.

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Gynecology Questions and Answers | Gynaecologist | Most Important Questions to ask

PCOS and Contraceptive Pills by Heena

Gynecology Questions and Answers With Expert Gynecologist Dr. Heena Chawla

Gynecology questions and answers, In this video SimpliHealth expert Gynecologist Dr. Heena Chawla is talking about very common questions that people ask in the OPD.

Why are contraceptives used for PCOS/PCOD?

The most commonly asked is the pills, i.e Contraceptive pills that our experts have prescribed for 21 -24 days for any reason like PCOD/PCOS. As a  contraceptive or for  fibroids. So they are given for a reason. So they come and tell us that they didn’t have proper bleeding at that time or had significantly less bleeding. 

When Should contraceptive pills be taken?

When the ovulation is stopped, the concentration of progesterone is reduced, due to which the innermost layer of the uterus that is endometrium doesn’t get that thick. So obviously, if the endometrium doesn’t get thick, it’s thin, then the bleeding will be less. 

So this is the after effect of the medicine.It is the mechanism of action of these pills due to which the bleeding is less. As soon as the pills are stopped, the body regains its process, and in the very next cycle, the bleeding pattern is set again—those females who are taking injections for  contraception after every three months. the bleeding may stop for a longer duration of time. So, in this case, either we have to wait and watch, or administer some medicines to set the menstrual pattern again. Another thing females often feel during periods is nervousness or anxiety. 

Premenstrual syndrome (Gynecology Questions and Answers)

There are different features, some may have headaches or some may have cramps, or some may feel pain in their legs. Due to this, one may develop fear, anxiety, and panic situations. They think it’s only with them, but it is a very common condition, more commonly called premenstrual syndrome. So this PMS is commonly found mainly in the young age group. It is prevalent in them. So in this, first of all, we don’t have to panic, start doing some exercise because the anxiety level and stress level is reduced.

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Top Common PCOS Questions and Answers | PCOD Patient | अधिकतर पूछे जाने वाले PCOS/PCOD वाली सामान्य दिक्कतें

PCOS and PCOD Q&A

Top Common PCOS Questions and Answers

Top Common PCOS Questions and Answers, In this video, our expert gynecologist Dr. Heena Chawla answered some very common questions about PCOD/PCOS.

What are periods like when you have PCOS?

Top Common PCOS Questions and Answers, In PCOD patients, the bleeding pattern is very different. In some cases, women don’t have periods at all, or it comes in the form of spots. It is a ubiquitous feature in PCOD. So the reason may be that in PCOD, ovulation, the rupturing of the egg, is delayed. So when it is delayed, the periods are also delayed. So the inner lining of the uterus, i.e., endometrium, doesn’t get enough hormones. Due to hormonal imbalance, there is a very thin layer of the endometrium; hence the periods don’t run for a long time.

Another very common question people ask is that most of the time in PCOD, 

Why does PCOS cause heavy bleeding?

If one has not received periods for 2 or 3 months, they may suddenly have heavy bleeding. See what happens in routine; when we have periods, the body secretes anticoagulants which don’t allow blood to clot during the time of shredding of the inner lining of the uterus. But due to some unknown reason, the flow is increased heavily; the endometrium layer is gone very thick, so time body doesn’t get enough time to secret the anticoagulant to counteract the blood flow. So in these cases, heavy bleeding may occur.

In many cases in women, periods are coming, and after the period is over, there is clotting of blood or bleeding. For this, our experts will say there may be many reasons for this. First, there may be ovulation spotting, which means bleeding during ovulation or implantation bleeding when you are about to have pregnancy. 

There may be endometrial polyps, which means a knot formed in the inner layer of the endometrium is called polyps, due to which spotting may occur. Also, in the case of uterus cancer, this spotting may occur. So if you have any of these, you should immediately visit a gynecologist; if needed, get an ultrasound and discuss it; get it examined, and then only we will come to know the reason for this bleeding. Often, no treatment measures are required for ovulation bleeding or implantation bleeding. 

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Uterine Cancer Symptoms | Endometrial Cancer | गर्भाशय कैंसर के कारण, लक्षण और उपचार

Endometrial cancer(uterine cancer)

Uterine Cancer Symptoms, Endometrial Cancer(uterine cancer): Is endometrial cancer genetic?

Uterine Cancer Symptoms, In this video SimpliHealth expert gynecologists Dr. Heena Chawla is talking about Endometrial cancer(uterine cancer). Also she is answering some very common questions like:

  • Is endometrial cancer genetic?
  • What are the symptoms of Endometrial cancer?
  • How can we tell who has endometrial cancer?

Endometrial cancer or uterine cancer or what we call common language can be uterine cancer. Endometrial cancer occurs, that is, the innermost layer of the uterus – the endometrium, the presence of any abnormal growth inside it, which can further turn by multiplication of cells leading to cancer; we call it endometrial cancer. 

Endometrial cancer symptoms | Uterine Cancer Symptoms

Uterine Cancer Symptoms, 90% of endometrial cancer is found in postmenopausal females. The woman does not menstruate for one year, perhaps at the age of 50-45 years, we say it is menopausal. Any kind of bleeding after menopause, Even if it is spotting, experts should get it checked, consult your doctor to find out the bleeding is happening. Earlier this cancer used to be more prevalent in the western world also due to changes in lifestyle, the prevalence of endometrial cancer has increased here drastically. 

In addition, it can also be found in some younger age groups, especially as per our experts its Peri-Menopause, which is the age group of 40 when we are going towards menopause as well as heavy bleeding. For women, it is a very good cancer that gives us symptoms early, like bleeding after already menopause; this is the first sign. It is not necessary that if we are bleeding after menopause, then we have endometrial cancer; no, endometrial cancer occurs in only 10% of women who have bleeding after menopause. 

There can be many other reasons why we do have bleeding after menopause, but until we can prove that it is not cancer, we continue to accept that there is bleeding; we have to do a biopsy to prove whether it is cancer or not. Biopsy means we take a piece test. From inside the innermost lining of the uterus, we take a piece and send it to the lab for testing. 

Then we know what kind of changes are happening inside the cell and what kind of cells are developing. 

Is it precancerous, is it progressing to cancer, or is there another reason that can cause bleeding? 

This biopsy is what we call an endometrial biopsy. What this biopsy is, based on the findings of your ultrasound. First of all, whenever we go to the gynecologist that we are bleeding after menopause, we need to do a basic ultrasound. Ultrasound sees the measurement of the inner lining of the uterus, its thickness, which is what we call endometrial thickness. 

If this thickness is more than 11mm after menopause which is a normal state should be between 4-5mm. So if it is more than 11 mm, your doctor will recommend a biopsy. But if you are bleeding and have gone to the doctor, and your endometrial thickness is less than 11 mm, they will still recommend you for a biopsy. Now, based on your ultrasound findings, your doctor will go for a hysteroscopy. A thin, lighted tube is inserted inside the uterus, which we call hysteroscopy. 

What are the benefits of hysteroscopy? (Uterine Cancer Symptoms)

Suppose inside the uterus; if there is a small area inside its wall where those cells lie together, or there is growth, we can see with the lighted tube and even take the sample for biopsy, we send it to the lab for examination. According to the report of endometrial Biopsy, your doctor will guide you further treatment. 

Suppose if experts have endometrial carcinoma, say Biopsy, we have endometrial carcinoma. On that basis, your doctor gives you further investigation, or MRI, PET-CT, such a test, wherein the body cancer has spread, we get all the simple information. Based on that, your decision is made about what treatment we have to give. Your doctor will examine you clinically, look at your PET-CTor MRI report, and then the decision is made whether or not to have surgery first. 

Endometrial cancer treatment

The most crucial treatment for endometrial cancer is your surgery, which we call Staging surgery, which is done by gynae cancer specialists i.e., gynaec-oncologists. This surgery is not just to remove the uterus. It is an extensive surgery in which your uterus is removed, all the tubes and ovaries are removed, apart from that we lymph nodes, that is, all the vessels that are lying around our uterus, Small lymph nodes are lying on them, arteries, veins. It is necessary to remove them because this is endometrial cancer. When the body may spread, it spreads only through the lymph nodes. 

First of all, it spreads by going inside the lymph nodes in our pelvis. After the pelvis, it spreads to our main blood vessel above the aorta, the lymph nodes lying around them, which we call para-aortic lymph nodes, then it spreads till there. So this is our lymph node dissection; it is an important rather than the first part of Staging surgery, which is the first surgery, this significant part of it. Apart from this, we may have surgery, wherever we find cancer to be spread, all of them come out, and we send them as much as our specimen, we send them to the lab for examination. Many patients ask, 

what will be the treatment further, or will I have to take chemotherapy, or will have to take radiotherapy further, what kind of treatment will come. 

See, whenever the specimen goes to Lab, its report comes. So, according to that report, some of our primary criteria are fixed, depending on what is your age, what is the size of your cancer or what is the stage of your tumour, what is the grade of your tumor, it depends on all these, your lymph nodes. It depends on the above factors whether you need any other type of treatment or not, and if there is, then there are different types of chemotherapy, different types of radiotherapy, what kind of treatment is needed. The second important thing, when we say that all the patients also ask that if there is cancer, 

How much time do we have and how long will we do it? 

See, the survival rates inside endometrial cancer are pretty good because it is such cancer that tells itself by giving a signal; like our experts said before that bleeding happens right after menopause. So somewhere it tells itself by giving its symptoms, but yes there are some aggressive varieties that are also inside it or there are bad variants in which it has survival rate, its survival rate is less, such as sarcoma, or clear cell carcinoma is done. 

So it is such a 2-3 variety in which the cells of endometrial cancer multiply rapidly and spread to the rest of the body as well. Apart from that, patients ask a common question: 

What do we need to do a Biopsy? 

If we come straight out of the uterus and give it, then the work will be done. So see, this is the significance of Biopsy that we have done Biopsy, then after that our treatment is defined as to what kind of surgery we need. Suppose we did not do a biopsy and remove the uterus directly, what will happen after the removal of the uterus that we came to know later that cancer came, then we have a second surgery or We will have to take more radiotherapy chemotherapy sessions because our initial surgery was incomplete, there were neither proper lymph nodes inside it nor proper staging, nor where it had spread, it could be taken out. So that’s why Biopsy is the first step which we should get done according to our doctor’s advice. After that, all our treatment depends on it.

That’s why our experts advises everyone that if you have any kind of heavy bleeding or spotting or heavy bleeding after menopause, then immediately talk to your doctor. Take advice from them, do necessary investigations and if they recommend you for biopsy, then definitely get it done from them. Your entire treatment plan will be according to that. Thank you.

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Ovarian Cyst Symptoms | ओवेरियन सिस्ट के लक्षण, प्रकार व उपचार | ओवरी में सिस्ट क्यों हो जाती है?

Ovarian Cyst Symptoms | ओवेरियन सिस्ट के लक्षण, प्रकार व उपचार | ओवरी में सिस्ट क्यों हो जाती है?

Ovarian Cyst Symptoms(ओवेरियन सिस्ट के लक्षण): Types, Symptoms, Treatment, & More in Hindi

Ovarian cyst symptoms, In this video SimpliHealth expert gynecologist Dr. Heena Chawla is talking about Ovarian Cysts and its types, symptoms, treatment and prevention. Also she answered some important questions that people ask more often. Like:

  • Why have I been advised to have surgery?
  • What are these ovarian cysts? 
  • Which surgery is needed?
  • What type of medicine would have been cured?

What are ovarian cysts? | Ovarian cyst symptoms

There are two fallopian tubes surrounding the uterus and they have ovaries on both sides. These are the ovaries, whenever any lump or tale of water gets filled with fluid or material, then they become a cyst. It is a common thing to have this cyst, sometimes it happens that women go to their routine for ultrasound, and because of which it comes to know that they have a cyst in their ovaries. many 80 Percentages diagnosed with ovarian cyst do not require any treatment, those cysts go away on their own. But yes it depends on the type and size of the cyst.

Types of Ovarian Cyst

Ovarian cyst symptoms, It all depends on whether any treatment is needed for the cyst or not. Very common question patients often come to the OPD and ask is that there are more ovarian cyst varieties or why do I see it happening to me. Or infertility patients who are taking treatment for getting pregnant, sometimes what happens is that a very small cyst is made in our ovaries, these are called poly ovarian cyst. 

This happens due to lifestyle changes like western change, work, eating, and drinking habits have changed. Now we know about the types of ovarian cyst, the first follicular cyst, as now the woman’s period is over. During that time the hormones are upper down, it is near the day of ovulation when the ovary is lying in the follicles and when there is an egg rupture from inside then we call it ovulation then it is exposed if it is not egg rupture then it is not called corpus luteum.

Those who grow up and in simple language call it corpus luteum cyst, no need to take any treatment for this cyst, mostly it dissolves on its own.

The third type of cyst is the polycystic ovary, which we talked about earlier, in which very small cysts are formed. What happens in this, as we talk about it, cysts of very small size like 3 to 4 mm size become cysts. It starts changing a lot in us, the weight starts increasing, hormonal imbalance happens, acne comes out on the face, and the hair on the face. According to our experts for this. We are together with the treatment and we need to talk with the doctor and to some extent, they are also cured by medicine.

Another one that we hear is very common is the chocolate cyst which means endometrial cyst. Why is it called a chocolate cyst? and When the blood accumulates too much and from inside it becomes the color of chocolate. What happens when retrograde flow begins during periods?. Ovulation causes blood to enter the fallopian tubes.

What happens when the retrograde flow starts during periods?

That is, through tubes from inside the uterus this blood starts pouring out, and then it starts accumulating at some places too. If this blood accumulates in the ovary, then we call it an endometrial or ovarian cyst. 

The main problem that comes here is that where this blood spills, the skin is sticky. There is a lot of adhesion due to the tubes, due to which the patient has a lot of pain and overflow during the period and sometimes it is difficult to conceive, due to which there are many adhesions due to which the patient has a lot of time in the period.

It is very important to seek treatment for endometriosis because there should be pain in periods or irregularities then it is causing infertility. Then you should consult your doctor for this. You have definitely needed treatment for endometriosis, even if it is claimed. Then if it is more then your doctor may ask you to have surgery for it.

Another thing to know is the cyst that we can have is a dermoid cyst and what happens like hair or fat or any cartilage or bone deposits inside this cyst. Some special differences from what we claim in a dermoid cyst.

It doesn’t matter, the most important thing is that the torizon means it moves from its place hence  Dermoid cyst requires surgery

Ovarian Cysts Symptoms

Some may have swelling in the abdominal area, so some may have difficulty passing urine and there may also be swelling (swelling). Periods can also be irregular and these are some of the symptoms that can be seen in ovarian cysts. 

Ovarian Cysts Diagnosis

For diagnosis, experts first do an ultrasound. If the doctor has any doubts during the ultrasound. If the doctor suspects something then we can go for a higher examination like MRI or CT scan can be done in this case. 

What happens if we put medicines for this but it can happen for some cyst problems?

The medicines are not effective. It can give you pain or it can be bigger or it could be a dermoid or endometriosis cyst,  then the doctor may advise you to go for the operation. Only 5 to 10% of patients require surgery. Now if we talk about surgery, many patients ask, 

Ovarian Cysts Surgery 

It depends on what type of cyst the patient has and also whether the patient wants to conceive in the future or not. It depends on what type of cyst the patient has and it also depends on whether the patient wants to conceive in the future and our experts preserve the ovary but if it is suspected to be cancer then what do we do when we remove the ovary too. Both the surgeries can be done very easily by laparoscopy. In this, experts make a small 5 cm hole above the navel or above the navel. In this, 2 or 3-5 mm holes are made in the remaining parts of the stomach. 

So doctors separate the cyst from the ovary and then we come out through small holes. These laparoscopic procedures are all daycare, a patient can go on the same day and can go home on the second-day maximum. One can resume his normal activities in 5-7 days

If this is done by abdominal cut then you need to rest for a longer period of time. The important thing about this is that it can happen again. It can be recurrent and in some of these, it may happen very often.

The important thing about this is that it can happen again. It can be recurrent and in some of these, it happens very often. 15 to 25% of cysts are only likely to be recurrent. The ovarian cyst in a hundred patients then only fifteen to twenty patients are likely to have this ovarian cyst reoccur. One more thing patients often ask is if cancer will not come in reports and how scared we should be? 

Whenever there is any such cyst diagnostic for cancer markers that  would suggest that you visit your gynecologist they will make an action plan for you. In addition, we do a test called a tumor marker to determine what type of cyst it is. At this stage decide whether you want pregnancy or not and what is the size of the cyst. In this step decide whether you want or don’t want pregnancy.

What is the size of the cyst and what are your symptoms? | Ovarian cyst symptoms

Further, it depends on the biopsy report what kind of surgery we need.  Most of the time the patient says they have no problems, but the doctor lays out the basics of the ultrasound. The doctor finds something suspicious then some cysts have imaging parameters that make them look more suspicious. So on that basis most of the time doctors recommend surgery. Removal of an ovarian cyst does not impede your chances of getting pregnant or infertile unless the ovary is removed.

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Pelvic Pain Causes | पेल्विक दर्द का कारण? | Pelvic Congestion Syndrome | What causes pelvic pain?

Pelvic Pain Causes | पेल्विक दर्द का कारण? | Pelvic Congestion Syndrome | What causes pelvic pain?

Pelvic Pain Causes(पेल्विक दर्द का कारण?): What causes pelvic pain?

Pelvic pain causes, In this video SimpliHealth expert gynaecologist  Dr. Heena Chawla is explaining about pelvic pain and also she answered some questions that people usually ask like:

  1. Causes of pelvic pain
  2. Types of pelvic pain
  3. Acute pelvic pain
  4. Chronic pelvic pain

In simple terms, the pain in the lower tummy is usually pelvic pain. This could be because of gynaecology and non-gynecological reasons.

Non-gynecological reasons could be Irritable Bowel Syndrome (IBS) or Interstitial cystitis, bladder infections, appendix, or there can be some other cause of this pain.

There are a number of gynaecological reasons for this pain. There are two types of pain that can be caused, acute and chronic. Chronic pain persists for more than 6 months in a row. This pain is not only during periods but otherwise as well. 

Acute Pelvic Pain

  • Periods: Acute pain can arise in different conditions. In this new generation, young females experience severe pain during periods. This pain during periods is called Dysmenorrhea. This pain is sometimes so much that the patient has to get an injection to relieve the pain. 
  • Ovulation: Besides this, some may even experience acute pain on one side of the abdomen during ovulation. Which is the 12th or 14th day of the cycle when the egg ruptures from the follicle. It is called mittelschmerz syndrome. Some may feel it a little and some would not feel it at all. 
  • Abortion: The third reason for this pain can be when after the pregnancy, during an abortion. In this, there is acute severe pain along with bleeding. Or, it would pain before clots and the process of abortion. It is also called threatened abortion. 
  • Pregnancy: Another reason is ectopic pregnancy. In this condition, the baby does not develop in the uterus but grows in the tubes or ovaries. 
  • Ovarian Cyst: Acute pain can be felt if the cyst in your ovaries twists. This twist is called torsion. And due to twisting the blood supply to it breaks and that causes acute pain. This torsion or rupture is another common reason for acute pain seen in women.
  • Urinary Tract Infection: It is seen in women who have UTIs and also experience acute pain in the lower abdominal area. This distressing pain is due to inflammation. 
  • Pelvic Inflammatory Disease: In Pelvic Inflammatory Disease there is inflammation in the entire pelvic region. This can cause pain and vaginal discharge. In some women, this can be treated with medications and in some, this pain persists and becomes chronic pain. 

Chronic Pelvic Pain

Now we will talk about chronic pelvic pain. It is not talked about so frequently but a lot of females suffer from it. This can have a number of causes. 

Chronic Pain 

  • Endometriosis: The most common cause that we see in our OPD practice is endometriosis. In this, the innermost layer of the uterus, the endometrium, starts growing outside the uterus. It starts growing on the ovaries, the bowl, or sometimes it reaches the urinary bladder. The places where it grows, start to stick together. We call this adhesion. When the organs stick together they cause severe pain. The pain is so severe that the female with this problem cannot even carry out her everyday tasks during periods. 
  • Fibroids: The other very common reason is fibroids. When the fibroids grow in size, they cause heavy bleeding along with severe and gradually increasing pain. 
  • Pelvic Inflammatory Disease (PID): Besides this, as we talked about before, a lot of patients suffer from pelvic inflammatory disease. Also called PID. There is continuous vaginal discharge. Sometimes this infection ascends. It reaches the tubes. Therefore the pain is persistent. 
  • Ovarian Cyst: If any ovarian cyst has persisted for a very long time, the pain increases gradually. 
  • Adenomyosis: There is another problem, which we also call endometriosis interna. In this, the blood is collected somewhere in the muscle layer of the uterus. And then during periods, it gives such a stretching sensation that it hurts a lot. This pain restricts you from doing any work. 
  • Previous surgeries: There are patients who have gone under surgery. So somewhere the pain of the surgery scares the pain persists. 
  • Cancer: Now there are a few cancer patients. In the early stage, they may not feel the pain, but as cancer grows the pain persists. 

So all of these are the causes of chronic pelvic pain.

Bottom line 

So, in the end, I would suggest that you consult a gynaecologist. Do not suffer, get diagnosed. There are simple blood and ultrasound investigations to diagnose the conclusion. After diagnosis, get your treatment accordingly.

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Apollo Clinic Chandigarh Gynecology

Ovulation Bleeding Symptoms | कैसे पता करे आपको ओवुलेशन हो रहा है?

Ovulation Bleeding

Ovulation Bleeding Symptoms: कैसे पता करे आपको ओवुलेशन हो रहा है?

, In this video SimpliHealth expert gynecologists  Dr. Heena Chawla is talking about ovulation bleeding symptoms and also she will answer some important questions that people usually ask like:

  • Is bleeding even after the 7 days cycle normal? 
  • Do I need any treatment for this? 
  • Bleeding after periods end. 
  • Ovulation bleeding vs Implantation bleeding

The bleeding we are talking about here is called ovulation bleeding. It is the bleeding that happens during ovulation. 

What is Ovulation?/क्या होता है ओवुलेशन?

On the 12th or 14th day of the period, one follicle grows big. When this follicle matures, it gets ruptured and releases eggs. This process is called ovulation. 

Mild bleeding or spotting is seen during ovulation. This is only seen in 5% of the females. 3-5 women in 100 experience this bleeding. This bleeding is light pink in color, as it is mixed with the cervical discharge. 

Why does this happen?/कब होता है ओवुलेशन?

  • This bleeding happens when the estrogen levels in our body decrease.
  • Women who take oral contraception can experience bleeding, as these pills affect the hormones. 

When the estrogen levels in the body drop, we call it breakthrough bleeding. This bleeding is for the first 2-3 months when we start the OC pills. And then later, this problem settles down. It happens mid-cycle. It gets better on its own. No special treatment is required. 

Ovulation Symptoms: How would we know that the bleeding is ovulation bleeding?

Our body shows signs and symptoms that indicate the start of the ovulation cycle. The body’s basal temperature rises. Transparent sticky vaginal discharge is seen. Some women may also experience abdominal pain and breast tenderness. The level of luteinizing hormone or the LH also elevates. This can be tested with the test kits available in the market. A few women also experience bloating during this time. If you note all these changes and signs then you might be able to know your ovulation period. 

Ovulation bleeding vs Implantation bleeding

It happens mid-cycle. Implantation bleeding is very different. There is a notable difference between the two. Implantation bleeding happens 6-7 days after ovulation. This bleeding would be seen after 20-22 days after the start of the cycle or 6-7 days before the next cycle starts. Implantation bleeding is thought to happen when the fertilized egg attaches to the uterus lining. The embryo creates a hole where it attaches itself, which may cause bleeding. 

One very simple way is to differentiate between ovulation bleeding and implantation bleeding. Implantation bleeding would happen before the start of the cycle.

  1. It would happen mid-cycle. 
  2. It has a pinkish discharge. And implantation bleeding has a little brownish discharge. 
  3. If you take a pregnancy test after the implantation bleeding, it would be positive. 

There is no treatment required in any of these bleedings. In implantation bleeding, we see other signs of pregnancy as well, like nausea, bloating, vomiting, light abdominal pain. 

You should not panic during these bleedings. Instead, visit your gynecologist and consult them about this bleeding and also how to further manage this pregnancy. 

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Apollo Clinic Chandigarh Gynecology

Best Treatment For Fibroids | फाइब्रॉएड के लिए सबसे अच्छा इलाज।| Uterine Fibroids | Causes, Symptoms, & Treatment  

Best Treatment For Fibroids | फाइब्रॉएड के लिए सबसे अच्छा इलाज।| Uterine Fibroids | Causes, Symptoms, & Treatment  

Best Treatment For Fibroids, Uterine Fibroids(फाइब्रॉइड): Causes, Symptoms, & Treatment 

Best treatment for fibroids, In this video SimpliHealth expert Gynaec Laparoscopic and Cancer Surgeon Dr. Heena Chawla will talk about  Fibroids(फाइब्रॉइड) and its causes, symptoms, & treatment.

My friends and colleagues often call me regarding heavy bleeding. They have to change pads, menstrual cups, or tampons very frequently. So they are worried if they have फाइब्रॉइड. I would like to clarify that फाइब्रॉइडare not always the cause of heaving bleeding. But they are the most common reason why most females experience heavy bleeding. 

  • Is there any medical treatment for फाइब्रॉइड, or is surgery the only option? 
  • Does it cause problems in conceiving? 
  • Can it cause multiple abortions? 
  • Can it cause back and stomach aches? 

Today we will be answering all these questions.

What is fibroids?/क्या है फाइब्रॉएड? | Best Treatment For Fibroids

Fibroids are simply tiny muscle knots, which are formed inside the uterus. More than half of the females are unaware that they have fibroids. फाइब्रॉइड can be detected in the ultrasound, which the patient does for other reasons. 70% of the females do not have any symptoms of फाइब्रॉइड. We have just detected fibroids in the ultrasound test. And the other 30% of the females experience symptoms like heavy bleeding, backache, or abdominal pain due to फाइब्रॉइड. 

So, फाइब्रॉइड are muscle knots that arise in the uterus. 

Fibroids Causes/फ़िब्रोइड कैसे होता है?

A lot of patients come to me and ask, what causes fibroids? There are various causes of fibroids, but science has not yet found a definite reason that we can pin the blame on. 

  • Hormonal imbalance: The imbalance of Estrogen and Progesterone hormones in the female can put her at risk of getting fibroids. 
  • Genetics: The risk increases if there is a history of फाइब्रॉइड in the family. That is, if the mother or elder sister have फाइब्रॉइड.
  • Alcohol: Alcohol abuse can also put the female at the risk of getting फाइब्रॉइड. 
  • Obesity: It is found that females who are obese are at higher risk of getting फाइब्रॉइड. 
  • Menstruation: Females who start their periods at an early age are more likely to suffer from फाइब्रॉइड. 

Fibroids Diagnosis

How are fibroids diagnosed? How does one know they have fibroids? 

The first is, you go to the gynecologist, and he examines you and finds out you have fibroids. The second is ultrasounds. Like we said before, you detect fibroids in an ultrasound test. Once you have found out that you have fibroids, an MRI is suggested by the doctor for further investigation to determine the exact number, size, and locations of fibroids.

The uterus has three layers: 

  1. Endometrium (inner layer)
  2. Myometrium (muscle layer)
  3. Serosa (serous layer) 

The fibroid cyst can be in any of these layers. If it is in the innermost layer, then we call it submucosal fibroid. If it is the middle layer, it is called intramural. And if it is in the outermost layer, we call it subserosal fibroid.  

Fibroids Symptoms

The symptoms of fibroids vary according to the location of the it. 

Endometrium 

The submucosal फाइब्रॉइड, situated in the innermost layer, causes the most symptoms like heavy bleeding, discharge, problems in conceiving, and recurrent abortion. 

Myometrium 

Moving on to the middle layer, the फाइब्रॉइड in the middle layer of the uterus cause fewer symptoms. 

Serosa

The Subserosal फाइब्रॉइड is found on the outermost layer of the uterus. These are the least problem-causing fibroids. Even if they grow in size, they do not cause many troubling symptoms.

Till now, we’ve talked about heavy bleeding, but what are the other things that happen? 

Backache and abdominal pain can occur. The fibroids grow in size up to 10, 12, 14, or even 16 cm and start putting pressure on the neighboring organs. So the patient starts showing pressure symptoms. 

Front 

If the fibroid is on the front side of the uterus, it will put pressure on the urinary bladder. This can cause symptoms like frequent urination. 

Rear 

If the fibroid is on the rear end of the uterus, it will put pressure on the rectum. This can cause constipation. 

Fibroids of this size can cause pain or swelling that can go down to the legs; this is called radiating pain or swelling. 

Fibroids Treatment/फाइब्रॉइड ट्रीटमेंट

We’ve talked about the symptoms; now, we will discuss the treatment for fibroids. 

It is not necessary that the patient has to get surgery after the फाइब्रॉइड are detected in the ultrasound. Or it is also not necessary that we have to take medicines in all cases. 

The treatment depends on the size, location, and number of fibroids, and whether the family is completed or they want to have more babies.. Based on all these things, a decision has to be made to choose the treatment method. Many patients come to us complaining about 2-3 cm big fibroids, with no symptoms, no heavy bleeding, no backache, no abdominal pain. Then, in this case, the patient needs neither medicine nor surgery. The patient is only put under observation. After a while, a scan is done to see how the fibroids are behaving. 

Some of them just stay the same size and do not cause any problem. For fibroids this small, there is no need to worry. Some patients worry about these fibroids turning into cancer. However, fibroids are very simple benign knots. There is a less than 1% chance of fibroids turning into cancer. Every 1 in 5 women in India suffers from fibroids. 

Now talking about the treatment of fibroids, there are 2-3 treatment options available for fibroids.

Medication | Best Treatment For Fibroids

Simple medication is stated for patients who experience heavy bleeding. These are non-hormonal medications. Besides, if we do not see any result with these medications, we start treating fibroids with hormonal medications. 

There is a 21 days pack, estrogen, and progesterone combined pills or just progesterone pills. So we prescribe these to the patient to control the symptoms. 

Other hormonal pills also help reduce the fibroids size. There are GnRH analogs or other hormones, but they cause side effects as they are stronger. 

Hormone-coated Copper T 

The second option for treating fibroids is hormone-coated Copper T. this is different from normal Copper T, as it is coated with hormones. This Copper T is inserted into the uterus and releases low doses of hormones. The advantage we have using this is that this action is only effective in the uterus, whereas the other hormone pills affect other parts of the body. 

Using hormone-coated Copper T helps regulate periods, correct heavy bleeding, and improve the standard of living. And it also acts as a contraceptive. But it is not like we can use this for every patient. In cases where the fibroid is large or is putting a lot of pressure on the inner parts of the uterus, or the uterus has grown in size because of it, then we cannot use hormone-coated Copper T. 

Surgery | Best Treatment For Fibroids

The third option of treatment is surgery. If the female has plans to start a family, and the fibroid is on the inner layer of the uterus, then it becomes very important to remove the fibroid surgically. This is because the baby needs a place to attach itself. 

In females who do not plan to have a baby in the future, this treatment option is considered. There are two types in this. If the female wants a baby, then we only remove the fibroid. And in females who do not plan to have a baby, we remove the uterus itself with fibroids. 

This surgery is done through laparoscopy. Even the big can be surgically removed by laparoscopy. 

Bottom line 

In the end, I would say you should consult a gynecologist. Discuss all the treatment options and then decide which medicine or surgery or hormone-coated Copper T would be best for you. Sit with your doctor and discuss if you need the surgery or not. 

Discuss all this and make a decision. Thank you.

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Copper T Side Effects (कॉपर टी) Uses, Efficacy, Benefits, Procedure | कॉपर टी का प्रयोग कैसे किया जाता है?

Copper T Side Effects

Copper T Side Effects: Efficacy, Benefits & Procedure | कॉपर टी से नुकसान?

Copper t side effects, In this video SimpliHealth expert Gynaec Laparoscopic and Cancer Surgeon Dr. Heena Chawla will talk about Copper-T(कॉपर टी) efficacy, benefits, side effects, & procedure.

What type of contraception should I get? Pills? / Copper-T? / the hormone coaxed Copper-T my doctor was telling me about ? Or injections would be better? 

These are very common questions and problems for every couple at some point in their life. Today we will be answering all these questions. Patients always come to me with the question, what is the difference between hormone-coated Copper-T and normal Copper-T, and which one should be opted for? 

  1. Plane Copper-T: We all know is coated with only copper and is inserted inside the uterus. And it creates an environment that is not sperm friendly and thus prevents pregnancy. 
  2. Hormone Copper-T: It is basically a ‘T’ shaped device, and the vertical limb of the device is coated with hormone. This hormone is called Levonorgestrel, and it is released in the body in small doses. This release of hormones causes the uterus walls to become thin and thickens the mucus at the cervix. So this way the sperm has no space to move up in the uterus. And even if the sperm gets in the uterus, the wall of the uterus becomes so thin that the egg cannot stay on the wall. So this is their mechanism of action. 

Which copper should you use? Copper-T is good or bad? 

Copper-coated copper is a contraceptive and any female can go for it. But the hormone-coated कॉपर टी has an additional advantage, it regularises the women’s period. So women who suffer from heavy bleeding, may it be because of adenomyosis, endometriosis, or endometrial hyperplasia, which is when the inner wall of the uterus becomes very thick, should opt for hormone coated Copper-T. 

Copper-T Advantages

The one major advantage of hormone-coated Copper-T is that if the female has all these problems, migraine, heart disease, or a history of clot deposit; it is suggested to put hormone कॉपर टी as additional hormone pills cannot be prescribed to them.  The other difference is that the copper-coated कॉपर टी is available for three years, five years, or ten years. And the hormone Copper-T comes mostly for five years. After that, they are supposed to be replaced or removed. 

If we talk about the procedure and its time, then the plan Copper-T takes about 5-10 mins for the Copper-T insertion procedure. And for the hormone-coated कॉपर टी, we first have to do a biopsy to check for other problems and then insert it. A biopsy is done if we insert a hormone-coated कॉपर टी because of your heavy bleeding. As a contraceptive, it can be inserted anytime. 

Copper-T side effects and symptoms after inserting/कॉपर टी से नुकसान 

The most common side effect that we see is cramps. It is very normal as the uterus is a muscle structure, and if we insert something in it, it will respond. And when we insert a Copper-T, the uterus reacts with cramps. Some people may experience backaches, irregular periods, spotting, etc. Irregular periods and spotting are only seen when the patient has a hormone Copper-T inserted. It usually resides in 3 months. After that, the body adjusts to it and the period cycle goes back to normal. 

कॉपर टी लगवाने के बाद प्रेगनेंसी

There is another very rare side effect of using Copper-T. In some patients with the insertion of Copper-T, their pregnancy can be affected. However, this happened to only 1% of the people. The other risk is ectopic pregnancy, i.e., the egg growing in the fallopian tube. 

Besides this, the other side effect of Copper-T seen in patients is displacement. The कॉपर टी displaces itself inside the uterus. The Copper-T has strings attached to it. And the patient should visit a gynecologist periodically to get it checked. If the doctor does not see the strings or the कॉपर टी is not visible in the ultrasound, it is not in its position. Either it went inside the uterus or has been expelled, or it has come out on its own. 

So the side effects for both are the same. 

Copper-T Removal

This is a very simple procedure. Quick and easy. The patient should visit the gynecologist to get the Copper-T removed.  Many patients ask me if they can remove the Copper-T on their own, and to them, I suggest not to do so.  One must feel the strings of the कॉपर टी every month, but you should not think of removing it on your own. Technically it is a little difficult; even if you pull on the strings, the कॉपर टी would leave its position but would not come out entirely.  Therefore, I suggest you go to your gynecologist to get the कॉपर टी removed properly. 

The second thing people say is that they’ve put the कॉपर टी for five years or ten years, and they haven’t gotten it removed yet, so what are the risks involved? 

The biggest risk that one has due to this is infections. Anything inside the uterus which has served its purpose and has overstayed its purpose, can cause infections. The other thing is that we have inserted it as a contraceptive, and it has lost its effect, so we are at higher risk of pregnancy. The females who plan to start a family after the period of contraceptive ends, this infection in the uterus can become a cause of infertility. 

Doctors advice 

My advice to everyone is to visit a gynecologist; they would suggest which Copper-T is the best for you, considering your bleeding pattern and other contraceptive measures. 

So this must always be discussed with your gynecologist. 

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