Frequently Asked Questions

Ques- 1) What is HPV?

Human PapillomaVirus is a very common infection that can be spread through sexual contact. Studies suggest that three of every four people who have sex will get a genital HPV infection at some point in their lives. Sexually transmitted HPV can be spread through vaginal, anal, and oral sex. Some types of HPV can cause cancer of the cervix, vulva, vagina, and penis.Genital warts are not usually linked with cancer. To lower your risk of developing HPV, limit your number of sexual partners and use condoms. If you are between the ages of 9-26, you should have the HPV vaccine to help protect you from infection. Regular pap tests are the best way to prevent precancer and cancer of the cervix.

Ques- 2) What ia Premenstrual Syndrome (PMS)?

Premenstrual syndrome (PMS) is a term used to describe the abnormal symptoms many women experience one to two weeks before the beginning of their period. Physical symptoms, accompanied by mood swings and depression, are the classic signs. PMS symptoms can occur any time after ovulation, approximately two weeks after the beginning of your period. Ways to decrease incidence of PMS symptoms include: decrease caffeine, avoid salt, avoid sugar, stop smoking, decrease alcohol intake, increase calcium, increase exercise, increase magnesium. All PMS symptoms should disappear rapidly once menstruation begins.

Ques- 3) What is Pelvic Inflammatory Disease?

Pelvic Inflammatory Disease (PID) is not a single illness but a broad term covering a variety of infections of the internal reproductive organs. The most common symptom of PID is a dull abdominal ache. Other signs include fever, vaginal discharge, abnormal uterine bleeding, fever and chills and sometimes nausea and vomiting. The symptoms vary among women and some women do not have symptoms at all. Sexual activity and movement often makes them worse. There are several bacteria that can cause PID. Gonorrhea and Chlamydia are the most common.

Ques- 4) What is Polycystic Overian Syndrome?

Polycystic Ovarian Syndrome (PCOS) is one of the leading causes of female infertility and is associated with long-term health risks of heart disease and diabetes. Three features of PCOS are

1) enlarged ovaries containing multiple, small cysts;
2) excess androgens (male hormone); and
3) chronic amenorrhea (missed periods).

Symptoms include: hirsuitism, irregular/lack of ovulation, obesity, acne/oily skin, infertility, ovarian cysts, insulin resistance, and hair loss.The diagnosis is made through a careful history of symptoms along with physical findings, blood work and ultrasound testing. There is no cure for PCOS. The treatment of PCOS is generally symptomatic and centers on life-style modifications and medication.

Ques- 5) What is Cervical Dysplasia?

Cervical dysplasia is a term used to describe the appearance of abnormal cells on the surface of the cervix, the lowest part of the uterus. These changes in cervical tissue are classified as mild, moderate, or severe. While dysplasia itself does not cause health problems, it is considered to be a precancerous condition. Left untreated, dysplasia sometimes progresses to an early form of cancer known as cervical carcinoma in situ, and eventually to invasive cervical cancer. Mild dysplasia is the most common form, and up to 70% of these cases regress on their own (i.e., the cervical tissue returns to normal without treatment). Moderate and severe dysplasia are less likely to self-resolve and have a higher rate of progression to cancer. The greater the abnormality, the higher the risk for developing cervical cancer.Cervical dysplasia does not cause symptoms; therefore, regular screening and early diagnosis are important. Detecting and treating dysplasia early is essential to prevent cancer. For this reason, most physicians quickly remove suspicious cervical lesions and require frequent Pap smears to monitor for recurrences.

Ques- 6) What is Insulin Resistance?

Insulin resistance (IR) is a condition in which the cells of the body become resistant to the effects of insulin. As a result, higher levels of insulin are needed. Reproductive abnormalities include difficulty with ovulation and conception (infertility), irregular menses, or a cessation of menses. Once insulin resistance is diagnosed, it is controlled by medication and lifestyle changes.

Ques- 7) What is ENDOMETRIOSIS?

Normally, during the menstrual cycle tissue builds up and breaks down within the uterus. In endometriosis, endometrial tissue (tissue from the lining of the uterus) is found outside the uterus. During the menstrual cycle this tissue builds up and breaks down in the same way but there is no way for it to leave the body. Women with endometriosis have symptoms ranging from mild to severe, although some women have no symptoms at all. Symptoms can include menstrual cramps, pain during sex, low back pain, constipation, pain with bowel movements, and infertility. Some women have chronic pelvic pain. Symptoms are usually at their peak just prior to and with the menstrual period.When your medical history and exam suggest endometriosis as a possibility, a laparoscopy may be offered to diagnose endometriosis. Endometriosis is usually treated with medications first and if that is unsuccessful possible surgery.

Ques- 8) What are FIBROIDS?

Fibroids are benign growths that develop from the cells that make up the muscle of the uterus. The size and location of fibroids can vary greatly. They may appear inside the uterus, on its outer surface, or within its wall.The two most common symptoms are abnormal uterine bleeding and pelvic pressure. Menstrual periods with fibroids may be very long and very heavy. There may be pressure in the pelvic region from the enlarged uterine size caused by the fibroids. However, many women with fibroids never have any symptoms at all.If you have uterine fibroids you should be checked by your doctor on a regular basis. Getting regular checkups and being alert to warning signs will help you be aware of changes that may require treatment.

Ques- 9) What is Laparoscopy?

Laparoscopy is an operation done to look inside your abdomen with a thin instrument called a laparoscope. Through small holes in your tummy, the doctor looks, examines and operates (if needed) without making large cuts.

Ques- 10) What are the advantages of a laparoscopic surgery?

In conventional surgery a long incision is made to gain entry into the abdominal cavity and operate. This result in increased post-operative pain, longer stay in hospital, delayed recovery, long and ugly scars, higher chance of wound infection and a higher chance of hernia. The incidence of all these are considerably reduced by a laparoscopic surgery.

Ques- 11) What is to be expected after a laparoscopy surgery?

There may be some discomfort in the abdomen for a day or two after laparoscopy due to the presence of some carbon dioxide gas. If the surgery is uneventful, feeding can be started on the same day once the patient has recovered completely from the effects of anesthesia. Before you go home you will be given advice about caring for the surgical wounds and when you will need to come back for a follow-up appointment or to have stitches removed. Complete recovery may take longer if any surgery has been carried out. It is important to follow the advice of your surgeon about physical activity, rest and returning to work.

Ques- 12) When may a hysteroscopy operation be needed?

Hysteroscopy for diagnostic purposes is usually performed to assess the cause of sub fertility or find out the cause of abnormal bleeding. It may also be done to remove polyps, resect septae, release adhesions and retrieve lost IUCDs.

Ques- 13) What are the functions of the ovaries?

Ovaries produce eggs and female hormones, which are required for normal menses till 46 to 50 years of age. At this age, all eggs are finished and no more female hormones are produced. This results in menopause. The woman stops having menses even if she has an intact uterus.

Ques- 14) What is HRT?

HRT is Hormone Replacement Treatment. Women take this when there are no female hormones in the body. This can be prescribed after natural menopause or after surgical menopause.

Ques- 15) What is HRT?

HRT reduces the hot flushes, night sweats, irritability and mood swings associated with menopause. It also reduces the risk of fracture amongwomen after menopause.

Ques- 16) How will I know that my menstrual bleeding is heavy?

30% women do not recognize heavy period bleeding. Passing of clots, prolonged bleeding for over a week and flooding are rough indicators of heavy bleeding. The most predictive indicator however is blood hemoglobin estimation. Normal values should be between 12 and 14gm%.

Ques- 17) When does heavy bleeding need treatment?

When heavy bleeding is significant enough to cause anemia or severely interferes with one’s quality of life it should be treated. Abnormal heavy bleeding may need investigation and treatment when suspected to be associated with malignancy.

Ques- 18) What could be the causes for heavy bleeding?

Hormonal imbalance is one of the most common reasons for heavy bleeding. Besides this, tumors of the uterus, infections, endometriosis, malignancies could also cause heavy bleeding.

Ques- 19) Pregnancy is a very crucial time window in a woman’s life. Doctor, please tell us - How should a woman prepare herself for pregnancy?

If a couple is contemplating pregnancy, the lady should start taking folic acid in the form of tablets, at least one month beforehand. She must have a healthy diet, drink lots of water and have regular intercourse with the partner between day10-day21 of her menstrual cycle every day or every alternate day. Commonly people, with no infertility issues, conceive by day14 or 15 if they go by these practices.

Ques- 20) Is there any medical test that is required to be done before pregnancy?

These days, before getting married, people get tested for Haemoglobin Electrophoresis i.e., Thalassemia screening programme. So, as long as the couple knows that only one/none of them is a carrier, there is not much of a risk of having a baby. However, if both the parents are a carrier of thalassemia, then they should consult the doctor before planning for pregnancy.

For health conditions like haemoglobin total count, blood group and type, tests can also be done. These days, we are seeing infection profiles like TORCH - Toxoplasmosis, Other (syphilis, varicella-zoster, parvovirus B19), Rubella, Cytomegalovirus (CMV) and Herpes infections. If vaccination has not being done, one can take rubella, MMR, RVAC vaccine. After 3-6 months of taking the vaccination, they can try for pregnancy.

Ques- 21) What is the basic health care one must adopt immediately upon being tested positive for pregnancy?

Once a lady knows that she is pregnant, she must start with her folic acid tablet intake if not started before. The couple must visit their gynaecologist/obstetrician regularly and religiously.

Ques- 22) What kind of diet should pregnant women follow?

The pregnant lady must follow a healthy diet. There are no such restrictions in diet. Green leafy vegetables, all kinds of fruits, potatoes, spinach, rice, bread, fish, chicken, eggs – everything is allowed. However, it is better if spicy food is avoided because it may cause gastric irritations. And in itself, pregnancy is a condition which causes gastritis. Old sayings go that pineapple and papaya cause miscarriage; however, this lacks scientific backing. So, on these, I don’t want to comment upon – but, all other food items are allowed.

Ques- 23) Upon being tested positive for pregnancy, does one run an increased risk of any specific complications or conditions?

Once someone is pregnant, there is a 5-10% risk of miscarriage. This is true for all pregnant women. Similarly, there is always a 3% risk of the baby having genetic abnormalities. Few ladies may end up with an ectopic pregnancy – the pregnancy is not in a proper position in the uterus but in the fallopian tube. The list goes on. One need not be scared of these; one must be mindful. Say, if one notices vaginal spotting, the sudden absence of nausea – they must contact the doctor. Sometimes, missed abortions happen and the lady cannot identify by herself that a miscarriage is happening. One must routinely visit their doctor who will guide them if there are any complications.