Female infertility specialist in Pune

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Good day bloggers.

The month of March is observed all over the world as an endometriosis awareness month. While reading many recent journals for updates, and guidelines, we were getting updated about numbers, the gravity of endometriosis and the challenges ahead of us.

While being in clinical practice where every patient is unique and the symptoms appear to be as diverse as non-menstrual abdominal or pelvic pain, Infertility, Painful sex, or bowel-related symptoms, Bladder pain along with Lower back pain, Bloating, and consistent fatigue.

Endometriosis may be at the root of all of these symptoms, sometime in silent form or may be intense in the future and as the disease may present in different ways in different individuals. Unbearable pain is a constant complaint in the above cases.

Very difficult to diagnose based on a few scans and tests along with silence to bear with situations makes it hard for all. We are here to put the concerns of endometriosis beyond assumptions.

Let us find out more about endometriosis.

What is endometriosis?

ENDOMETRIOSIS is a condition where endometrial tissues and adhesions are found outside of the uterus and these cells respond to hormonal changes as if, they are within a uterus. such cells may be found in the bladder, pelvic region and bowel and other organs too. Such lesions of endometriosis get attached to other organs too. Such conditions then can cause intense pain as well as inflammation.

Endometriosis is not a period disease.

Unlike during regular periods, the pain of endometriosis isn’t caused by contractions of the uterus, but instead, comes from uterus tissue growing elsewhere in the pelvic cavity. This inflammation often results in a lot of pain. The intense pain from endometriosis can occur regularly, even in the absence of a menstrual cycle. Menstrual pain can be managed with over-the-counter pain killers whereas endometriosis pain is severe and may not be managed with over-the-counter painkillers alone. Period pain is labelled as dysmenorrhea and goes away after the periods.

It is a spectrum disease with a variety of subtypes and symptoms like pain, inflammation, infertility, development of endometriomas (“chocolate cysts”), fibrosis, formation of adhesions (fibrous bands of dense tissue), Gastrointestinal and other organ dysfunction, and much more, are common with endometriosis.

Detection of endometriosis takes time:

The real reason behind this lengthy detection is symptoms which are many and every patient may have different complaints. The silence kept over the symptoms often causes a delay in seeing an expert. To understand endometriosis, let us know about symptoms which cannot be ignored and can help to seek the help of an expert.

Symptoms often reported but not limited to are,

Pelvic Pain in the abdomen, Painful intercourse and sexual activity, Leg pain, lower back pain etc. Most of the time, symptoms appear to be on the surface and are mild. As time passes, lesions go deeper and chronic symptoms become noticeable. Does it mean, every symptom is of endometriosis? No. Rather, put it like this. We need to know, what is normal and what not so normal or causing concern is. Watch out for the symptom intensity, duration, frequency, medication response, and symptoms’ reoccurrence. Make a note of it and keep it handy as it can form the basis of the right history taking.

So, when should you go to the doctor?

If the pain is severe and comes days before the period and persists after the period, then it could be endometriosis. See a gynaecologist and get tested. Another indication is if the pain doesn’t go away after taking painkillers or other analgesic pills, or over the period, intensity, duration & episodes increase with time.

Endometriosis is certainly not in your head, and we hear your silence.

Let’s understand that pain has intensity and every individual has a different tolerance capacity. That is why we at Pearl Women’s hospital understand your pain and developed a protocol to address your concerns. We understand pain as an obstacle that affects your daily routine and needs prompt treatment.

Endometriosis slowly and steadily takes over the body, intensity increases over time. You may be scaling new highs on the personal as well as professional front while being with endometriosis. Gold standard Laparoscopic examination may confirm the diagnosis and we understand, not all illnesses are visible and still be powerful to affect lives.

Let the silence be deleted and let’s practically know more about endometriosis.

Endometriosis is rare, what is your take?

Endometriosis is not rare as there is 10% of women suffer from it, which means 1 out of 10 women suffer from it.

Endometriosis is now a commonly diagnosed condition in gynaecology and you are not alone. The cases like PCOS and uterine fibroids are widely seen and spoken about but with endometriosis, the case is different. As there is no defined biomarker or blood test which can reveal endometriosis, its severity and progression. It simply does not mean, there is no progress in understanding disease in depth. There are multidisciplinary approaches to reducing effective symptoms.

After detection and with a surgical approach, can endometriosis be cured?

Currently, there is no cure for endometriosis, there are treatments available to reduce the symptoms and their intensity. The key whole surgery is still major surgery. There are multiple options available to control symptoms like medications, IUDs, surgeries, Pelvic floor physiotherapy, Prescription pain killers, supplements etc.

Your treatment plan will be tailor-made as per your conditions and may not be identical to others,

Be gentle to yourself. It ok, if you are not performing at your best sometimes.

Let’s understand some facts in a nutshell

As of now, Endometriosis has no cure but effective treatments are available which offer relief.

Endometriosis is a chronic, systemic inflammatory disease.

Treatment for endometriosis is not the same or one size fits all approach.

Pregnancy is not a cure for endometriosis

Birth control can offer temporary relief.

The right diagnosis at right time is the key which helps in the faster and more effective treatment

The silence over endometriosis is a matter of concern

A lot needs to be done and the least we can do is, seek the guidance of the right doctor.

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The word endometriosis is often uttered with great pain & anxiety. Every case of endometriosis is an enigma and calls for a deeper understanding of causes beyond the symptoms. Clear understanding about the same will raise awareness and reduce suffering. In this blog, we will address endometriosis in the most genuine scientific way.

Endometriosis is a condition in which tissue outside of the uterus resembles the uterine lining (endometrium). Endometriosis can grow on the exterior of your uterus, ovaries, tubes, or even your bladder and intestines. This tissue can irritate the organs it contacts, producing pain and adhesions (scar tissue).

The average wait period for a diagnosis for women is 6.7 years. This prolongs their suffering, which frequently leads to mental health problems.

The difficulty of diagnosis is just one factor that contributes to this delayed diagnosis.

Aside from bias in medical research, it is not unusual for women’s suffering to be underestimated in comparison to men’s.

Many women with endometriosis have pelvic or abdominal discomfort, which is worsened by menstrual bleeding or intercourse. Some women have no symptoms. It might be difficult to get pregnant if you have endometriosis. Endometriosis affects 30 to 50 percent of infertile women. Endometriosis can sometimes develop inside your ovary and produce a cyst (endometrioma).

This causes an inflammatory response, which can lead to the formation of scar tissue and the sticking together of pelvic organs. Debilitating pain during menstruation, painful bowel motions, pain while urination, pain during sexual intercourse, and fatigue are just a few of the symptoms. It is also associated with an increased risk of infertility.

Unfortunately, there is no full-proof treatment for endometriosis. Though hormone therapy can help with symptoms, it is also known to have negative side effects. Endometriosis lesions have to be surgically removed, but the risk of relapse can’t be ruled out.

Endometriosis affects 10-15% of all menstruators, according to current statistics. Because of the number of cases that go undiagnosed, this number might be significantly higher. Despite the high frequency, women must wait an average of 6.7 years for a diagnosis. This prolongs their suffering, which frequently leads to mental health problems.

The difficulty of diagnosis is one of several factors that contribute to the delay in diagnosis. There are no blood tests that can be used to diagnose this condition. Doctors can diagnose one with endometriosis based on their symptoms, but a definitive diagnosis requires surgery. Due to their similar symptoms, endometriosis is frequently misdiagnosed as irritable bowel syndrome or appendicitis.

Unlike other endometriotic tissue, this may usually be detected on ultrasound. A surgical procedure known as laparoscopy is the only method to determine if you have endometriosis for sure.

The lack of study using female animal models is one of the key reasons why women’s health concerns are misdiagnosed. Male animals were commonly utilized more than female animals since they were regarded to be less variable due to the lack of monthly hormonal cycles. As a result, the majority of studies favored male subjects.

Research organizations are still debating the ideal mammalian model to use for studying difficulties particular to the female body. Aside from bias in a medical study, it is not unusual for women’s pain to be underestimated in comparison to men’s. This may be linked back to a history of women being labeled as “hysterical” if they complained of pain that wasn’t immediately apparent.

The concept that a displaced uterus was the cause of pain from an unusual, seemingly invisible sickness was first mentioned in ancient Greek texts. This gave rise to the concept of ‘hysteria’ as a mental disorder, paving the way for modern-day women to be informed that their seemingly intangible pain was “all in their heads.”

As a result, it is typical for women’s pain to be ignored or trivialized. In reality, the phrase “gender pain gap” was developed to address discrimination in healthcare, when unconscious bias causes women’s pain to be dismissed as unimportant.

If you have endometriosis, becoming pregnant may be more difficult. Women with endometriosis might have infertility in 30 to 50 percent of cases. Endometriosis can affect fertility in a variety of ways, including distorted pelvic anatomy, adhesions, scarred fallopian tubes, inflammation of pelvic structures, immune system dysfunction, changes in the hormonal environment of the eggs, impaired pregnancy implantation, and reduced egg quality.

Your doctor may assign you a “score” based on the quantity, location, and depth of endometriosis. This number defines whether your endometriosis is mild (Stage 2), moderate (Stage 3), or severe (Stage 4). The success of pregnancy is linked to this rating system.

Women with severe (Stage 4) endometriosis, which results in significant scarring, blocked fallopian tubes, and damaged ovaries, have the most difficulties conceiving and usually require advanced reproductive treatment.

The female hormone estrogen is needed for endometriosis to develop and grow. Birth control pills and other estrogen-lowering or estrogen-blocking medications can help relieve pain symptoms. Medical therapy may be considered for patients who want to get pregnant before attempting to conceive, however, this treatment usually improves pregnancy rates.

If endometriosis is detected during surgery, the endometriosis will be surgically destroyed or removed, as well as the scar tissue. This treatment will return your anatomy to normal and allow your reproductive organs to function normally again. After surgical treatment, your chances of becoming pregnant improve, especially if your endometriosis is moderate or severe.

In individuals hoping to conceive through in vitro fertilization, a mix of surgical and medicinal treatment may be useful (IVF). Overall, each patient’s treatment is very personalized.

As a sufferer of endometriosis, it takes almost five years to receive a correct diagnosis. While some doctors invalidated my pain, others advised them to “get married” and “have children” to deal with it. To most people’s surprise, these experiences in cities like Mumbai and Bangalore. The Rural & urban divide is almost diminished in the case of endometriosis diagnosis & treatment.

However, it’s not all bad news. There has been growing interest in endometriosis research. A brief scan of PubMed, the most widely used scientific research archive, reveals that the number of studies on endometriosis has been rapidly increasing in recent years. In the late 1990s and early 2000s, there were only about 500 articles published every year. This number has risen significantly, with over 2,000 articles published in 2021 alone.

With new research advancing our understanding of the condition, more institutions are employing a multidisciplinary approach to endometriosis treatment. Some endometriosis clinics employ doctors who have completed fellowships in endometriosis surgery. Endometriosis procedures may now be performed in a minimally invasive manner as well, thanks to enhanced infrastructure.

Endometriosis remains unnoticed for two main reasons: lack of awareness and difficulties identifying the disorder. With medical advancements, minor but continuous efforts have been made to address the latter. Female-specific disorders such as endometriosis, however, are still poorly communicated.

Do consult an endometriosis expert to get the right diagnosis & treatment. Early diagnosis can reduce or correct the chances of fertility.

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It is said, pain is the language of the body that conveys the battle going on within the body. The body is designed uniquely to tackle the issues on its own but when the situation goes out of control, the body needs external support and help and indicates this by way of pain.

One such condition is Pelvic pain, which affects the lower part of the abdomen, between the belly button and groin. In some people, pelvic pain may manifest as menstrual cramps signifying ovulation. Causes may also include gastrointestinal issues, such as food intolerance. Pelvic pain may indicate more serious issues and proper evaluation is necessary.

Many women experience pelvic discomfort (pain in the lower part of the belly) on occasion, generally during their period. However, if you have daily pelvic pain, it could be a sign of a bigger problem within your bladder, bowels, reproductive organs, or pelvic muscles.

Endometriosis, adhesions, chronic appendicitis, and hernias are just a few of the disorders that cause pelvic pain. Sometimes medication controls the problem; other times surgery may be needed. Your doctor will examine you to identify the nature of the problem and the best course of action.

Your doctor will ask as to whether going to the restroom, walking, sitting, climbing stairs, or driving a car causes you pain. If you experience pain while engaging in these activities, it could be an issue with your bladder, bowels, or the muscles in your pelvis, hips, or lower back.

By pressing on these muscle areas your doctor may be able to determine exactly where the pain is originating. Problems such as endometriosis can cause pain because there may be tissue growth from the endometriosis on different organs within and outside of the pelvic cavity, which includes the ovaries, bladder, behind the uterus, and bowel.

Some doctors may suspect these problems during a pelvic exam & treatments are planned accordingly.

Conservative treatment means treatment without performing surgery. Depending upon the cause, your doctor may first try to treat your pelvic pain with medication. If you have endometriosis that may not work and you may be given medications that take away the estrogen in your body, therefore placing you in a short-term, menopause-like state. Endometriosis implants and pain can be reduced by lowering estrogen levels in the body.

Laparoscopy is a type of minimally invasive surgery that is performed with a telescope that is attached to a camera (laparoscope). The laparoscope is inserted into one of three to four small incisions made in your belly. During laparoscopic surgery, your doctor will be able to view your pelvic organs to see if they, or any other conditions, are contributing to your pain. Endometriosis, adhesions (scar tissue), appendicitis (appendix infection), or a hernia are some of the diseases your doctor may identify.

Finding out that everything is normal might sometimes be useful in deciding what treatment to follow.

The two most common problems that can be treated with laparoscopy are endometriosis and pelvic adhesions.

Endometriosis can cause discomfort in the pelvis on a regular basis, as well as painful periods and pain during bowel movements or intercourse. Endometriosis can also make it difficult to become pregnant. Your doctor will use an electric current or a laser to try to remove the endometrial tissue that is seen during your laparoscopy. Treatment will help to decrease or eliminate the symptoms.
Pelvic adhesions (scar tissue): Adhesions in and around the pelvic cavity may form if you have endometriosis, a pelvic infection, surgery on your pelvis, a cyst on an ovary, or have had surgery on your pelvis. Organs that are normally separated from one another become connected due to scar tissue. Pelvic discomfort might not usually require medical attention. However, if a person suspects an infection is causing pelvic discomfort, if they have unexpected vaginal bleeding and severe pain, or if they have a known illness and suffer rapid changes in pain, they should consult a doctor.

If a person with pelvic discomfort develops a fever, nausea, or vomiting, they should consult a doctor. A doctor will conduct a comprehensive evaluation and assist in the development of an appropriate treatment plan.

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Women of any age can experience abnormal bleeding, vaginal bleeding that is heavy, lasts long periods of time, or occurs outside of regular menstrual cycles.

The textbooks define abnormal bleeding as blood loss from the uterus in excess of 80 ml 0r 2.8 ounces. But frankly, does anyone have the where with all to carry out such measurements? Not really. If the uterine bleeding interferes with regular activities and disrupts your routine, or is painful or very heavy, it can be considered as abnormal and warrants a visit to your gynecologist.

Many women also have irregular periods, which come so seldom that they feel like they’re bleeding all the time or come so infrequently that they only bleed once every three to four months. Though from the women’s perspective, fewer periods may be desirable, it needs to be evaluated as this will directly affect chances of conceiving.

Abnormal bleeding or spotting often happens after active sex, between periods, or after menopause.

Abnormal bleeding can make everyday activities such as household working, attending to the duties exercising or socializing stressful and difficult. Some women even have to wear a pad as well as a tampon for protection, carry them always, yet remain under the stressful thought of bleeding all the time. They have been programmed to ‘bear it’ and so perceive the situation as ‘Heavy periods’ to be put up with.

You don’t have to live with abnormal bleeding because it’s not “normal.” Whether you’re a teen who is just starting to cope with abnormal bleeding or a woman in perimenopause who has been struggling for years, help is available. Let’s discuss the primary causes of abnormal bleeding, some common treatment options, and understand which associated conditions can exist.

To figure out what’s causing the bleeding, we need to figure out where it’s coming from. Is it coming from your uterus, cervix, or vaginal area? Bleeding that appears to be coming from the vaginal area may instead be coming from the bladder or bowels. The patient’s symptoms are often the indication of trouble, so after physical examination, which will generally include a pelvic exam to check the cervix and vagina as well as all potential sources of bleeding.

Cervicitis, a sexually transmitted illness, is one of the most prevalent causes of bleeding and discharge. The cervix, which is positioned at the lower end of the uterus, becomes inflamed and irritated. Often evaluation of the cervix for cancerous and pre-cancerous lesions is done.

However, abnormal bleeding can be the result of many conditions, mainly of the uterus (or the womb). Let’s identify primary conditions of the uterus that lead to abnormal bleeding:

Polyps: growths, or small clumps of cells, that form when cells in the lining of the uterus overgrow
Adenomyosis: Adenomyosis is a condition in which the tissue that borders the uterus grows into the uterine wall.
Leiomyoma: Fibroids are benign tumours in the uterus termed leiomyoma.
Hyperplasia and malignancy: when the uterine lining (endometrium) gets overly thick.
Coagulopathy is a condition in which the body’s ability to clot is harmed, generally as a result of low levels or the lack of blood-clotting proteins.
Ovulatory dysfunction occurs when ovulation is abnormal, irregular, or absent, and is a common cause of abnormal bleeding.
Endometrial: abnormal functioning of endometrial tissue
Iatrogenic bleeding: When bleeding is caused by birth control, other hormone medicines, or other pharmaceuticals, it is called iatrogenic bleeding.
Not otherwise classified: When doctors are unable to identify a specific cause for bleeding problems, they are labeled as “not otherwise classified.”
Following a physical examination, we may use ultrasound, endometrial biopsy, and other tests to assist us to identify the problem, which may include an infection examination. Finally, we go over the various treatment alternatives.
Bleeding that interferes with daily routine is not “normal,” and you don’t have to live with it. Whether you’re a teen who is just starting to cope with abnormal bleeding or a woman in perimenopause who has been struggling for years, help is available.

Many conditions can be treated with medication. If there is an infection, Simple antibiotics will relieve the problem soon. For many of the uterine sources of bleeding, hormone treatments such as birth control pills, progesterone pills, or intrauterine devices (IUDs) that help regulate and lighten periods, can be prescribed.

Patients may need minimally invasive surgery to remove abnormal tissue if conservative therapy fails or if they have uterine growth diseases like polyps or leiomyoma. The doctor may recommend a hysterectomy to remove the uterus in severe cases, and usually only after women are done with fertility. However, women should never feel pressured into hysterectomy as their only option since many treatment options are available today.

Excessive blood loss causes some women to develop iron-deficiency anaemia. When the blood is low of healthy red blood cells, this occurs. This condition can cause dizziness, fatigue, and shortness of breath, which impacts overall work efficiency.

Untreated abnormal bleeding caused by ovulatory dysfunction, which causes irregular periods in women, can put them at risk for precancerous endometrial disorders including hyperplasia, which occurs when the uterine lining swells and can lead to uterine cancer. Even if you like just three to four periods a year, this is abnormal and should be investigated.

Women who merely have a “lack of energy,” and when we get to talking about her period, we discover she’s had abnormal bleeding her whole life and never realised it was “abnormal.”

With simple evaluation & treatments available, it’s amazing to see women get their life and energy back.

Women should seek treatment for abnormal bleeding in time as her gynaecologist will help to enhance the quality of life and offer her much-needed respite from abnormal bleeding.

We can also secure a healthy future by addressing underlying issues. Make an appointment by calling or filling out our online form.

In addition to working with a doctor, some home remedies and supportive tools can help reduce symptoms and make an abnormal period easier to manage.

Try a heating pad: Heating pads can help reduce common period symptoms, as the warmth of the heating pad can relax the muscles involved.

Wear period panties to bed: Period panties are absorbent underwear that works like a pad to absorb blood.

Sleeping in these panties may be more pleasant than sleeping with a pad, and people may wake up less frequently at night.

Diet, supplements like Vit C, D, iron help in easing the burden of abnormal bleeding.

Nevertheless, it is to be taken under the guidance of a registered medical gynaecologists’ as, just easing the symptoms doesn’t mean the underlying problems are been taken care of.

A good old wise saying is apt for this; a stitch in time saves nine.

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Parents play a critical role in managing PCOS in an affected daughter. Chances are they have no idea what to look for and may simply ignore period problems as something that will settle down or ‘bad periods’. The probability that a father will even be consulted is practically zero, in India, except perhaps if he is a doctor and keeps his eyes open.

Even mothers may be slow to react simply because they themselves may have gone through the same difficult time and they were also told to ‘stay at home & bear with it’.

It is now a known fact that mothers and, yes, even fathers, can pass on PCOS to daughters.

As parents, you need to be sensitive to your daughters’ behaviour as much as her physical experience. A healthy lifestyle is something you need to inculcate in them and set an example. This doesn’t mean forbidding certain types of eatables but simply teaching them to maintain a healthy balance.

Observe for mood swings. PCOS is caused by hormonal imbalance and this will impact behaviour strongly. Unusual weight gain, excessive body hair, especially male pattern hair on the face chest, armpits are sure telltale signs. Persistent acne, thinning of scalp hair are also signs to watch for.

Mothers should monitor abnormalities in the monthly cycles and consult a gynecologist early if they find an abnormal pattern.

It’s common to put down your daughters’ mood swings to teenage transition. Keep in mind that if she has PCOS she has the additional burden of hormonal imbalance in addition to the peer pressures she will be experiencing. A supportive family can do wonders and the silver lining is the strong bonds this can create.

As parents, we must address any feelings of shame, guilt, rage, or sadness your daughter may be experiencing as a result of her trauma. While there is definite evidence that it can be passed down the generations, it doesn’t mean that you are responsible for it.

None of us is genetically perfect. In a few cases, this imperfection manifests more visibly. Not only in the form of appearance issues but moodiness, irritability. This being a part & parcel of living with PCOS, should be accepted and professionally addressed.

First of all, do not get into denial mode. That won’t help at all.

Accept that your daughter isn’t the perfect child that you wanted. Far from it. But your response will determine how she weathers the PCOS storms over the years. Channelize your frustration, guilt and anger in figuring out the best way to deal with the different manifestations of the problem. Easier said than done.

Accept that PCOS isn’t going to go away
Connect with a doctor who has had experience in dealing with such cases. More importantly, one who is qualified to do so? Do not put your trust blindly in the family doctor, who may simply tell you what you wish to hear.
Even a good doctor alone will not be enough. Ideally enroll in a clinic that has an all under one roof facility for dealing with PCOS including a nutritionist, Physiotherapist, lifestyle counselor and stress therapist. If they work in a coordinated manner as a team, this will really go a long way in helping your daughter to keep PCOS on a tight leash. Remember, the medicine will work only as long as the other facets of PCOS management are also being expertly managed, namely – nutrition, weight control, management of emotional issues.
Keep in mind that PCOS patients can get Diabetes, are at a much higher risk of heart disease & endometrial cancers. They may have to combat infertility. More the reason you need to get professional help at the earliest and keep on monitoring lifelong.
Keep in mind that she may not be the only one in the family with a major health problem. Her sisters may not be showing symptoms of PCOS, but maybe at a higher risk. Even the men in the family run a higher risk of getting ailments like diabetes, thyroid disorders.
Address the issues openly and supportively. Anger, frustration, and depression will not help. You, as a parent, need to appear in control. You need to give your daughter the confidence that she is not alone in this fight to counter her risks and build a lifestyle that is healthy. Even if it means changing your eating habits, taking time out of a busy schedule to go on walks or bike rides with your daughter. If you can’t do it, find someone who can and remain as involved as you can.
Teach her to cook healthy, even if you yourself have to unlearn what your mother has passed on! Take classes to learn how to cook simple, healthy yet delicious, wholesome meals.
Introduce her to Yoga, Pranayam and meditation. There are many meaningful courses in India that teach Life & Stress management in a way that is acceptable to youngsters. Attend these together.
Visit the clinic with her. Be prepared with your specific questions for the entire team – the doctor, nutritionist, Physio, lifestyle and stress counsellor. Encourage her to become a part of a group on social media, that deals with PCOS and whose members share their successes and failures openly.

Try to sweep away the fact of PCOS under the carpet
Make her feel like a burden or someone to be ashamed of
Let your emotions go out of control in front of her

Each of us is dealt a different set of cards by life. PCOS isn’t worse than a lot of problems that people have to deal with. Stay together as a family, support each other and life can be normal again.

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Are you bothered about the school-going daughters getting menstruations? It’s a whole new experience for every episode of periods. Parents tend to be extra cautious about the movement, pain, dresses they wear, and many questions as a family we, need to address.

Let’s touch upon this one by one:

Menstrual blood is made up of blood and a membrane from the uterus. If we don’t get pregnant during our cycle, the membrane that was created to support the possibly fertilized egg slowly departs our body. Sometimes blood can appear clotted or brown, but that is all normal.

While period blood is made up of normal blood, it is not the same as the blood we get when we get a cut, thus there is no reason to be afraid of menstrual blood.

Sometimes there can be a bad smell due to bacteria that grow in underpants’ moist, warm environment. Changing the pad regularly (once every 3-5 hours, or whenever the pad is full) will help keep bad smells away and reduce the risk of infection.

Yes. We may get abdominal cramping and a heavy feeling. Cramps occur when our uterus contracts to get rid of menstrual blood. Our breasts can also feel heavy and tender. Light exercise, hot water bottles, and warm baths can all help to reduce the effects of cramps. If the pain gets worse please visit a nearby health specialist.

It is normal for us to have discharge during our menstrual cycle. Discharge can be clear or yellowish. Discharge is protective because it can stop bacterial from entering our vagina. discharge changes to a strange color, or becomes smelly, that can mean that we have an infection and need to go have a check-up at a health facility.

Be prepared; keep disposable or reusable pads handy to absorb blood. Disposable pads are available in a variety of types, including those with wings, thin pads, and thick pads. There are also material pads that you can wash and reuse. It’s important to use the one that seems the most comfortable to you.

Change your pad one every 3 to 5 hours, and more regularly if needed. Always keep spare pads in your school bag, even if it’s not time for your period. It is better to be prepared, especially at school.

After using the toilet or changing pads, wash your hands with soap and water.

Wash the vagina during bathing, while changing pads with water & soap. Use a calendar to mark your menstrual cycle so that you can predict your next menstruation.

To avoid infection, wipe the vaginal area from front to back. Don’t put perfume, cream or other products on the vagina. If you notice a change like discharge a weird colour or funny smell, or the vagina feels itchy or hot, make sure you go for a consultation with the gynaecologist in case you have an infection.

Most girls experience this at least once in a lifetime. If you have a jacket, you can tie it around your waist to hide the stain. You may twist your skirt over so the stain is on the side if you don’t have a jacket. That way, no one will notice. Then, change your pad quickly so no more blood leaks. To prevent this from happening, it’s important to change pads regularly and always carry spare pads in your bag.

Carry dark coloured large scarfs to wrap around, take the help of peers to help you out in this regard.

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The arrival of PCOS in women is signalled by various symptoms, some of which are seen & some are deep-rooted. Every face of PCOD is equally important & interlinked. Every thread interlinks and so is excessive body and facial hair. This is called ‘Hirsutism’.

Hirsutism is indicated by coarse, black hair on the face, chest, abdomen, back, upper arms, and upper legs. Hirsutism is a sign of androgen hormone-related medical problems. Androgen is the primary cause of this.

Polycystic ovary syndrome (PCOS), in which the ovaries produce excessive amounts of androgens, is the most common cause of hirsutism, and may affect up to 10% of women. Hirsutism is a common condition that improves well with medical treatment. Prompt medical attention is important because delaying treatment can have prominent effects, which makes the treatment more difficult and may have long-term health consequences.

Hirsutism is more than hair growth which impacts overall personality.

Understanding the process of normal hair growth will us understand hirsutism better. Each strand of hair grows from a follicle beneath the surface of your skin. Hair will continue to develop as long as these follicles are not completely damaged, even if the shaft, or the part of the hair that appears above the skin, is plucked or removed. Except for the soles of your feet and the palms of your hands, hair follicles cover every surface of your body. Of the approximately 50 million hair follicles covering your body, one fifth is located on your scalp. After birth, the number of hair follicles does not increase, but it decreases gradually until around the age of 40.

There are two types of hair in adults: vellus and terminal. Vellus hair is silky, fine, and usually colorless, with a short length. Terminal hair is long, coarse, dark, and sometimes curly. Vellus hair covers the face, chest, and back of most women, giving the appearance of “hairless” skin. Terminal hair covers the face and body in most men. Both men and women have terminal hair on their scalps, pubic areas, and armpits. Both men and women have a mixture of vellus and terminal hair on their lower arms and legs. If you have excessive hair growth mainly on your lower legs and forearms, you don’t have hirsutism and hormonal therapy won’t help.

Excessive face and body hair are generally caused by an excess of androgens in the body. Males and women both have androgens, but men have significantly larger amounts of physiologically active androgens. Androgens are predominantly produced by the testes and adrenal glands in men. Androgens are produced by the ovaries and adrenal glands in women. Estrogen reduces the effect of androgens in women to some extent.

Androgens cause oily skin and acne by increasing sebum production. Ovulation and menstruation can be irregular or absent when there are too many androgens in the body. Extremely high androgen levels, such as those found in the presence of a tumor, can result in male-like baldness, a deeper voice, increased muscular mass, clitoris enlargement, and decreased breast size.

Polycystic ovarian syndrome (PCOS) is a chronic hormonal condition that affects 5%–10% of women. PCOS is diagnosed using a combination of clinical, ultrasound, and laboratory features because of its variable nature. PCOS (polycystic ovarian syndrome) is a hormonal imbalance in which the ovaries produce excessive amounts of androgen. It is one of the most common causes of hirsutism. Multiple small follicles develop in the ovaries in women with PCOS, resulting in cysts, hence the term “polycystic.” These small cysts are immature ovarian follicles that haven’t matured enough to ovulate.

You should be as precise as possible when describing your symptoms to your physician. Your medical history and physical examination may point to PCOS. To confirm the diagnosis and exclude certain other associated conditions, your physician may measure your blood hormone levels. If you have irregular menstrual bleeding, your doctor may do an endometrial biopsy to ensure that your uterus is free of precancerous cells.

You should be tested for PCOS if you’ve had menstrual irregularities and/or increased hirsutism since puberty.

Hirsutism is a common condition that may usually be successfully managed with medicines. Electrolysis or laser treatment can be used to permanently decrease or remove any remaining unwanted hair after medical treatment. If previous female members of your family have had excessive hair growth, keep an eye out for early indications of hirsutism in yourself and your children, particularly during adolescence.

Hirsutism is frequently a result of PCOS. When hirsutism and PCOS are diagnosed at an early age, they are easier to treat. Hirsutism, acne, irregular or heavy menstrual periods, lack of ovulation, and infertility are all symptoms of PCOS. Diabetes, uterine cancer, high cholesterol, and heart disease are all related to this condition. Despite the fact that the causes of PCOS remain unclear, progress has been made in both understanding and treating the condition. Your goals and concerns may be addressed in a very short amount of time if you are diagnosed with hirsutism or PCOS, and treatment is generally successful.

Nevertheless, alternative treatments may offer some relief, but evidence-based modern medicine offers deeper views on causes & concerns, addresses the short term and long term impacts of PCOS.

You should get a consultation from a Gynaecologist to address hirsutism in totality and face the world with new vigour and energy.

Beat the Hirsutism with winning stroke of evidence-based medicine and expert recommendations.

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Polycystic Ovary Syndrome (PCOS) has become extremely common, mainly due to poor lifestyle unhealthy eating habits and unawareness about the issues arising due to PCOS. These all add up to the noise level of PCOS. Research has shown that Living with PCOS can increase the risks of type 2 diabetes, it can make you overweight and cause obesity and improving your lifestyle can help in reversing PCOS.

PCOS (Polycystic Ovary Syndrome) is a syndrome in which cysts form in the ovaries. Because the ovaries do not produce eggs or ovulation on a regular basis, it causes irregular periods. High levels of male hormones are released in the body as a result of the illness, which can lead to excessive facial or body hair. The ovaries enlarge and become filled with fluid sacs called follicles, which enclose the eggs. You’re much more likely to be diagnosed with PCOS if you have two of these characteristics. PCOS also puts you at risk for unexpected weight gain and hormone imbalance.

PCOS, according to gynaecologists, nutritionists, and health professionals, is mostly a lifestyle-related condition. PCOS can be caused by a lack of exercise, bad eating habits, smoking, alcohol misuse, and poor sleep.

Without a doubt, irregular periods are the first indication of PCOS. It might be an indication of PCOS if your menstrual cycle is irregular, with periods that arrive earlier than 21 days and later than 35 days in adults and 45 days in young teenagers. PCOS can also manifest itself in the inability to conceive. If you’ve been trying for a long period of time, getting yourself diagnosed with it could be a good idea.
If you have oily skin or a lot of acne all of a sudden, it might be one of the first signs of PCOS that you should pay attention to.
Hair thinning and loss are other signs of PCOS and should be treated carefully if they continue for an incredibly long time.
Living with PCOS can increase the risk of type 2 diabetes – a condition that causes higher than normal levels of blood sugar.
Mood swings and depression are also known to be risk factors for PCOS. If you neglect PCOS for a long period, it can lead to hormonal changes and depression that are hard to manage. It can significantly lower your self-confidence and self-esteem.
PCOS is associated with high blood pressure and cholesterol. Heart disease and stroke can be caused by certain disorders.
PCOS can cause you to gain weight, which can lead to sleep apnea, a disease in which you stop breathing while sleeping.
Endometrial cancer, or cancer of the uterine lining, is a risk for women who have irregular or infrequent periods – less than 3 to 4 per year – for many years.
Skin darkening. Under your arms or breasts, on the back of your neck, and in your genital area, you may notice thick, dark, velvety patches of skin. Acanthosis nigricans is the name for this disorder.
The high levels of hormones that cause PCOS can also cause headaches.

It may be possible to control your symptoms by eating the right foods and avoiding certain ingredients. A healthy diet can help in the regulation of your hormones and menstrual cycle. Eating processed, extensively preserved foods can increase inflammation and insulin resistance.

It’s all about whole foods: Artificial sugars, hormones, and preservatives are not found in whole foods. These foods are as close as possible to their original, unprocessed condition. Fruits, vegetables, whole grains, and legumes are examples of whole foods that may be included in your diet. Your endocrine system may better manage your blood sugar without hormones and preservatives.
Balance carb and protein intake: Both carbs and protein have an effect on your energy and hormone levels. Protein stimulates the production of insulin in the body. Source foods are unprocessed and can help with insulin sensitivity. Rather of trying a low-carb diet, concentrate on eating enough high-quality protein. Plant-based protein sources, such as nuts, legumes, and whole grains, are the best Source. Anti-inflammatory foods should be included in your diet to help alleviate your symptoms. Consider going on a Mediterranean diet. Inflammation is treated by olive oil, tomatoes, leafy greens, fatty fish like mackerel and tuna, and tree nuts. Add magnesium in diet by using Almonds, cashews, spinach, and bananas. These are PCOS-friendly foods rich in magnesium & offer excellent stress reducer. Add in some fibre to help with digestion, a diet high in fibre can help improve your digestion. Lentils, lima beans, broccoli, Brussels sprouts, pears, and avocados are all rich in fibre and help in weight reduction.
Maintain a healthy weight: Maintaining a healthy weight can help you reduce insulin resistance, regulate your menstruation, and lower your risk of PCOS-related disorders. If you’re overweight, several studies show that a low-calorie diet combined with progressive weight loss is an effective first-line therapy for PCOS.
Balance your exercise: Maintaining a healthy weight requires regular exercise. However, too much exercise can cause hormonal imbalances, so talk to your doctor about maintaining a healthy balance. Gentle, low-impact exercises like yoga or Pilates can be practised for longer durations. Swimming and light aerobics are also recommended. High-intensity interval training and long-distance running may help improve symptoms of PCOS. Consult your doctor to determine the best sort of exercise for you.
Practice good sleep hygiene: Sleep increases your stress levels and helps in the regulation of cortisol, which helps to keep your hormones in balance. But sleep disturbances are twice as common Source for women with PCOS. Aim for 8 to 10 hours of sleep every night to improve your sleep hygiene. Create a consistent bedtime routine. Always avoid stimulants and rich, fatty foods before bedtime.
Reduce stress: Reducing stress can regulate cortisol Many of the measures listed such as yoga, getting adequate sleep, and avoiding coffee, can help reduce stress.

Consult your doctor to determine the best comprehensive ways to manage PCOS and avoid long-term effects, since one-size-fits-all treatment does not work. Your gynaecologist must prepare a treatment plan that is unique to you.

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Abnormal uterine bleeding (AUB) is a common gynaecological complaint associated with considerable morbidity and significantly affects the patient’s family, personal and social life. Abnormal uterine bleeding is the medical term for abnormalities in the frequency, volume, duration, and regularity of the menstrual cycle & occurs in absence of pregnancy.

It is a common gynaecological complaint accounting for one-third of outpatient visits to a gynaecologist. It is caused by a wide variety of organic or non-organic causes. An organic cause is a term used to describe any health condition in which there is an observable and measurable disease process, such as inflammation or tissue damage.

Non-organic causes are the one that shows the symptoms but whose disease process is either unknown or unable to be measured by current scientific means.

To understand better, let’s talk about, what is normal bleeding. This is appropriate for reproductive-age women (menarche to menopause), with bleeding occurring every 21 to 35 days, lasting 3-7 days, and a blood flow of 35 ml.

Bleeding from the vaginal area between periods is one of the signs of this illness. Extremely excessive bleeding during periods can also be caused by abnormal uterine haemorrhage. Menorrhagia is a condition that arises when severe bleeding continues for more than 7 days during periods or otherwise.

Polyps or fibroids, which are abnormal growths in the uterus, can cause AUB. AUB can also be caused by a cervical infection, a thyroid condition, or uterine cancer, among other causes. Hormone imbalance is also the known cause of heavy bleeding.

The disorder is called dysfunctional uterine haemorrhage when abnormal bleeding develops as a result of hormone imbalance. Dysfunctional uterine haemorrhage is more common in teenagers and women approaching menopause.

Treatment for abnormal uterine bleeding is determined by the patient’s age, the reason of the bleeding, and whether or not she wishes to become pregnant in the future. The different treatment options include the use of an intrauterine device, birth control pills, D&C (dilatation and curettage), endometrial ablation and hysterectomy.

There are many causes for abnormal uterine bleeding and that exactly defines the difference between abnormal uterine bleeding and dysfunctional uterine bleeding.

In both cases, menstrual bleeding and related symptoms exist but the causes are different. In case of dysfunctional uterine bleeding, it is directly linked to hormonal imbalances.

Intrauterine device (IUD): An intrauterine device (IUD) is a tiny plastic device that is put into a woman’s uterus through the vaginal canal. Hormones released by the IUD assist to prevent irregular bleeding.
Using birth control pills: They prevent the lining of the uterus from getting too thick & help to regularize the menstrual cycle and even reduce cramping.
D&C or dilatation and curettage procedure: The opening of the cervix is expanded so that a surgical instrument may be put into the uterus in the D&C or dilatation and curettage process. With the use of this instrument, the uterine lining is scraped away. The doctor then checks the removed lining for any abnormality and determines the cause of the abnormal bleeding. D&C is used to identify the source of bleeding.
Hysterectomy: It is a surgical treatment that involves the removal of the uterus. It prevents the patient from having any further periods and from becoming pregnant. It is normally performed under general anaesthesia and requires a person to stay at a hospital.
Endometrial ablation: This treatment removes the uterine lining rather than the uterus itself. As a result of the surgery, all forms of monthly bleeding are stopped.
Simple measures to cope up with: Abnormal uterine bleeding which arises as a result of any abnormality in the menstrual cycle and is most common. In the vast majority of cases, it can resolve itself without the need for therapy. Self-care methods and home remedies can also aid with the condition’s treatment.

The use of menstruation cups is one example of a lifestyle modification.
Use of heating pads which can ease the symptoms like abdominal cramps and severe pain.
Using period panties, for dry pad feeling, which offer sleep comfort.
Proper and adequate rest, Adequate hydration
Breathing exercises and yoga are good examples of regular exercises. These have a calming effect.
Consumption of adequate iron, vitamin C, and other minerals and vitamins supplements.
Even when a person can manage their heavy flow, it is still best to consult a doctor, who will investigate and identify any underlying issues. This can assist to lessen the flow’s intensity and duration. The menstrual bleeding disorder has a impact on other bodily functions. Right diagnosis &treatment is the key.
Take home points: Irrespective of any age group, menstrual disorders should not be taken lightly proper medical diagnosis & treatment not only offer relief but also reduce the future complications if any.

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Fertility changes with age. In women, this is very conspicuous and the window period of fertility is much smaller than in men. Males & Females attain fertility with the onset of puberty. For girls, fertility begins with the onset of ovulation and menstruation and ceases with the onset of menopause. Women can no longer conceive naturally after menopause, according to common belief.

In today’s scenario, age-related infertility is more common due to various reasons. Many women prefer to concentrate on a career for financial security and wait until their 30s to begin their families. Women take care of themselves better, so are far healthier & more updated about information available.

In general, women’s reproductive potential declines as they age, and fertility usually ends 5 to 10 years before menopause.

During their reproductive years, women have regular monthly menstrual periods because they ovulate regularly monthly. Eggs mature inside fluid-filled spheres in the ovaries – called “follicles.” When a woman has her period at the beginning of her menstrual cycle, a hormone released in the pituitary gland (located in the brain) promotes a number of follicles on both ovaries to develop faster. The pituitary hormone that stimulates the ovaries is named FSH (FSH). Normally, only one of those follicles will reach maturity and release an egg (ovulate); the remainder gradually will stop growing and degenerate. Pregnancy results if the egg gets fertilized and gets attached to the lining of the uterus. If pregnancy doesn’t occur, the endometrium is shed because conception hasn’t occurred and we say that the cycle has begun again.

In their early teens, girls often have irregular ovulation leading to irregular menstrual cycles, but by age 16 they ought to have established regular ovulation leading to regular periods. From 26 to 35 days, a woman’s periods will be regular until her late 30s or early 40s, when they will get shorter. As time passes, she is going to begin to skip ovulation leading to missed periods.

Ultimately, periods get prolonged or become infrequent until they cease completely. When a lady has not had a menstrual period for 1 full year, she is claimed to be in menopause. Fertility falls as women age due to natural, age-related changes in the ovaries. A woman is born with all of the egg-containing follicles in her ovaries that she will ever have, unlike men, who continue to produce sperm throughout their lives.

At birth, there are about one million follicles. By puberty – about 300,000. Only around 300 of the follicles left at puberty will be ovulated during the reproductive years. The majority of follicles are not used up by ovulation and are eventually lost due to atresia, a degenerative process that happens independently of a woman’s condition, such as pregnancy, normal periods, being on birth control pills, or being treated for infertility. Menopause appears to occur one year earlier in smokers than in non-smokers.

In her 20s, a woman’s reproductive years are at their maximum. Fertility gradually declines within the 30s, particularly after age 35. A healthy, fertile 30-year-old woman has a 20% chance of becoming pregnant each month she tries. That means that just 20 out of every 100 fertile 30-year-old women who try to conceive in one cycle will succeed, with the remaining 80 having to try again. By age 40, a woman’s chance is smaller than 5% per cycle, so fewer than 5 out of each 100 women are expected to achieve success monthly.

Women do not remain fertile until menopause. The average age for menopause is 47, but most women cannot have successful pregnancies in their mid-40s. These percentages are true for natural conception also as conception using fertility treatment, including in vitro fertilization (IVF).

Much misleading information is spread through the media, which often misinterprets the age impact and an attempt is made to make patients believe that fertility treatments such as IVF are the easiest way to get pregnant. The natural process of conception, as well as assisted techniques for pregnancy, are greatly affected by age. Great nutritional status, as well as the solid foundation of financial security, does not reverse the biological clock.

The success rate of infertility treatments is affected by a woman’s age. The age-related loss of female fertility happens because both the standard and therefore the number of eggs gradually decline.

Unlike a woman’s first reduction in fertility, a man’s sperm characteristics fall considerably later. Sperm quality deteriorates as men age, although it usually does not become a problem until a guy is in his 60s. Changes in fertility and sexual functioning do occur in men as they get older.

Despite these changes, the ability to father a child even in the 60s and 70s with a younger partner is possible

Men’s testes decrease and get softer as they age, and sperm morphology (shape) and motility (movement) tend to indicate no. There is a slightly higher risk of genetic defects of sperms, happening during DNA fragmentation.

Any illness like diabetes, BP adversely affect their sexual and reproductive function. Not all men, especially those who maintain their health over time, have major changes in reproductive or sexual functioning as they age.

Improved health status does not interfere with the natural age-related decline in fertility. It’s critical to realise that a woman’s fertility decreases as she ages due to the natural decrease in the amount of eggs left in her ovaries as she ages. This decline may happen much before most girls expect.

While addressing infertility age is the main contributing factor. There are other contributing factors like ovulation disorders, hormonal imbalances, tubal defects, varicocele, infection & uterine fibroids to name a few.

Older Posts

ENDOMETRIOSIS: BEYOND SYMPTOMS AND ASSUMPTIONS

Endometriosis: Tall Claim Over Infertility

What is Endometriosis?

Let’s Know, More About Endometriosis.

Does Endometriosis Cause Infertility?

How is Endometriosis Treated?

Managing Pelvic Pain: Finding Out What is Wrong?

Diagnostic Laparoscopy:

Abnormal Bleeding That Drains Life

What Causes Abnormal Bleeding?

Treating Abnormal Bleeding

What can happen if Abnormal Bleeding is Left Untreated?

PCOD / PCOS – Role of Parents

Do’s and Don’ts for Parents:

Don’t:

Menstruation Hygiene Simplified

Is Menstrual Blood the same as Normal Blood?

Does Menstrual Blood Smell Bad?

Are Cramps Normal?

What is Vaginal Discharge?

Let’s Find Out the Best Ways to Manage the Periods:

What to do When You Are Scared of Staining?

Hirsutism: Thread that Links

Normal Hair Growth:

Effects of Androgens on Hair Growth:

Diagnosing the Interlink is as important as the Treatment

Early Diagnosis is the Key to Hirsutism

Early Warning Signs of PCOS

Let’s go through some of the early warning signs of PCOS so you can take the necessary steps to control and reverse it.

Wiser way to control the PCOS:

Abnormal Uterine Bleeding (AUB): Healthy Womb & Happy You Series

Treatment Options Available for AUB:

Natural Ways to Reduce the Troubles Associated with Abnormal Uterine Bleeding?

FERTILITY IN THE AGING MALE & FEMALE

SIGNIFICANCE OF OVULATION AND THE MENSTRUAL CYCLE IN FERTILITY

FERTILITY IN THE AGING FEMALE:

FERTILITY IN THE AGING MALE: