female infertility - Pearl Women Hospital

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Good day bloggers. The month of May has arrived with a bang. May is celebrated as Women’s health month. So we, at Pearl Women’s Hospital are presenting the focus towards the routine concerns. A happy and healthy woman is an asset to the family and society. When the topic of irregular periods creeps in, concerns and mental agony are evident.

Carrying the pads to using dark-coloured clothes along with layers to cover up the body are not only traumatic events but also inconvenient. Irregular periods or missing periods are the basic factors that contribute to infertility. Such concern accounts for 30-40% of all female infertility cases to date.

A woman’s body is designed for pregnancy. The unique hormone-driven cycle starts with the thickening of uterine walls, followed by the growth of an egg. Once these follicles mature, the egg is released from the ovary into the Fallopian tubes. This is a process called ovulation, and the body awaits fertilization. After the arrival of sperm in the Fallopian tube, fertilization takes place and the formed embryo implants itself in the uterine walls causing a positive pregnancy.

In case, when fertilization does not happen, the uterine lining, known as the endometrium sheds itself, and the menstruation begins. This is a simple process of fertilization as well as menstruation. Irregular periods definitely cause problems in pregnancy.

What is menstrual cycle irregularity?

Menstrual cycle irregularity is defined as more than 7 days deviation between self-reported and ultrasound examination-based gestational age. On average, most of the women have a 28-day menstrual cycle, which can range from 24-35 days. Irregular periods are the ones that are either shorter or longer than the 24-35 day range. An irregular period is an indication of irregular or no ovulation, which leads to pregnancy problems.

Women have 11 to 13 Menstrual cycles per year that lasts around 2-7 days. However, the period timing and the amount of blood flow vary considerably. The amount of flow depends on how rapidly the endometrium sheds. Incomplete shedding often causes heavy flow and may cause anaemia.

What is a normal menstrual cycle look like?

Menstruation happens throughout the woman’s reproductive life in the absence of pregnancy. The average duration from 28-35 days with blood loss per cycle is an average of 30ml (normal range 13-80 ml).

Can you get Pregnant with Irregular Periods?

The key factor that matters the most in case of irregular periods is regular ovulation. The best way is to find out the reasons behind the irregular menses.

Few important ways to conceive with irregular periods are:

Correction or controlling the underlying health problems: Women affected with an underactive or overactive thyroid, obesity, etc., are commonly found to have irregular periods. In such cases, your fertility specialist will prescribe few medications or may suggest lifestyle modifications to manage such issues, which normalizes ovulation. This might improve the chances of conception.

Excessive Prolactin hormone: Excessive prolactin hormone is secreted by the pituitary gland, affecting the menstrual cycle. In such cases, medications can help women ovulate and conceive a pregnancy.

Unknown or undetected cause of irregular menstruation:

When the cause of irregular menstruation is unknown, fertility medications can be used to help women ovulate and conceive. Fertility medications are Oral and Injectable. Oral medications are given to women to regularize menses. These are inexpensive processes of normalizing ovulation. Injectable Fertility Medications are superior in normalizing the menses and help with conception.

Some factors that trigger irregular periods are extreme or intense exercise or dieting, stress which impacts hormonal balance, birth control pills, Polycystic Ovary Syndrome, Uterine Polyps or fibroids, Pelvic Inflammatory diseases, Endometriosis etc. Most of these conditions are caused by or resulted in hormone imbalances.

Thyroid disorders may cause irregular periods. The thyroid gland is responsible for growth, metabolism and energy. A simple blood test can detect any abnormalities in the thyroid functioning and irregular menses can be corrected.

In women with an ovulatory factor, IUI (Intra-uterine Insemination) with controlled ovarian stimulation can also be of great help. Stimulation medications can develop follicles to mature and release eggs, which can help women ovulate. After which IUI is done, to enhance the woman’s conception chances. IUI is the process in which sperm is picked up with a micropipette and directly injected inside the uterus. This way the egg and sperm are fertilized and can implant on the uterine walls.

For women, who are unable to conceive even with fertility medications or IUI treatment, IVF is often recommended. In-Vitro Fertilization treatment is the process in which the stimulated, good-quality eggs are retrieved from the ovaries and fertilized with the best-quality sperm in an IVF lab. The embryo is transferred back to the uterus to implant. With the advancement of technology and the use of modern labs, IVF treatment has helped countless women to conceive.

What are the Signs of Pregnancy while having Irregular Periods?

Some of the signs of pregnancy are tender breasts, lower abdominal cramps, frequent urination, increased appetite, nausea, etc.

Do Irregular Periods Mean Infertility?

Irregular periods do not always mean Infertility. If a woman is ovulating irrespective of her irregular periods, she can conceive. Women with irregular periods are advised to consult a fertility specialist to diagnose the exact cause and to improve the chances of conception.

How to test for pregnancy while having irregular periods?

If your periods are irregular or you don’t get periods at all, a good rule of thumb is to wait until 3 weeks after you have had unprotected sex.

In a nutshell, irregular periods are the indicators of ovulation concerns. It is important to know, the stabilization of periods happens over time. Due to changing lifestyles and fast-paced routines, menstrual irregularities are often seen. This brings in a lot of stress and anxiety on the personal and social front. There is a lot of research linking infertility with irregular menstruation. Nevertheless, early diagnosis and control of irregular menstruation can reduce the burden of pregnancy.

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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.

Irregular Periods & Pregnancy

ENDOMETRIOSIS: BEYOND SYMPTOMS AND ASSUMPTIONS