GENERAL GYNAECOLOGY

Dr Deepa, as your gynaecologist will 
She  addresses several  issues like menstrual irregularities,  PCOD ,vaginal infections, managing pelvic pain, uterine fibroids, ovarian cysts , endometriosis, recurrent urinary tract infection, sexual problems many other issues of women health.

GENERAL GYNAECOLOGY Commonly treated problems-

Dysmenorrhoea
Premenstrual syndrome
Heavy menstrual bleeding
Amenorrhea
Fibroids (leiomyoma)
Endometriosis and adenomyosis
Infections

DYSMENORRHEA
The most common gynaecological symptom reported by women. It affects between 50% and 90% of menstruating women.It can lead to absence from school or work; 13–51% report having been absent and 5–14% report being frequently absent. It can be primary- Usually begins in adolescence after the establishment of ovulatory cycles, therefore starts 6–12 months after the menarche, once cycles are regular.
Secondary dysmenorrhoea: Menstrual pain associated with underlying pelvic pathology

Management – lifestyle, diet, and complementary medicine

PREMENSTRUAL SYNDROME

A condition that manifests with distressing physical, behavioural, and psychological symptoms in the absence of organic or underlying psychiatric disease, which regularly recurs during the luteal phase of each menstrual cycle and disappears or significantly regresses by the end of menstruation.

• Mild – does not interfere with personal/social and professional life.
• Moderate – interferes with personal/social and professional life but still able to function and interact, although maybe suboptimally.
• Severe – unable to interact personally/socially/professionally; withdraws from social and professional activities.
• Precise aetiology is unknown but cyclical ovarian activity and the effect of oestradiol and progesterone on the neurotransmitters serotonin and γ aminobutyric acid (GABA) may be key factors. Clinical features
• Psychological – mood swings, irritability, depression, and feeling out of control.
• Physical – breast tenderness, bloating, and headaches.
• Behavioural – reduced visuospatial and cognitive ability and an increase in accidents.
• Record symptoms prospectively, over two cycles, using a symptom diary.

HEAVY MENSTRUAL BLEEDING

Abnormal uterine bleeding (AUB) is a common gynecologic disorder affecting  30% women of reproductive age.  AUB can present  as heavy menstrual bleeding (with passage of clots, prolonged bleeding  (>7 days ), frequent or irregular cycles (periods not coming on time)  or scanty periods .. AUB can be due to a functional abnormality (e.g., dysfunctional uterine bleeding [DUB]), organic abnormality(e.g., fibroids, endometriosis and adenomyosis ), or systemic disorder (e.g., vonWillebrand disease) or harmonal disorders.

If there is need to change your tampon or pad after less than 2 hours or you pass clots the size of a quarter or larger, that is heavy bleeding. Heavy and prolonged bleeding can cause anemia, tiredness, lack of energy.If you have this type of bleeding, you should see a doctor. It will can stop you from living your life to the fullest.

The treatment for AUB includes both medical therapies and surgical procedures.

Amenorrhea (missed period) requires evaluation most common cause is pregnancy but  but there are some other medical reasons and lifestyle factors that impact your menstrual cycle. Extreme weight loss, hormonal irregularities, and menopause are among the most common causes if you're not pregnant. Missed period requires evaluation.

FIBROID-Uterine fibroids are abnormal growths of muscle tissue that form in (or on) the walls of the uterus. Fibroids are benign (not harmful/life threatening), but can cause symptoms such as irregular vaginal bleeding and pelvic pain. Prevalence increases progressively from puberty until the menopause – 40–60% of women have fibroids by 35 years of age, which is increased to 70–80% by 49 years of age.

Uterine fibroids most often cause no symptoms at all and often shrink after menopause. In other cases, untreated fibroids may lead to problems such as heavy bleeding, anemia, pelvic pain or pressure, fertility changes, and complications during pregnancy. Symptoms  as well as treatment depends on the size, location, and number of fibroids.

Getting enough exercise and eating a balanced diet may also help with this. Specifically, a diet low in red meat and high in green vegetables may help to lessen the prevalence and severity of fibroids. Treatment depends on severity of symptoms and  desire for fertility.  Harmonal medications are used to treat fibroids. Myomectomy ( removal of fibroid) can be done by hysteroscopically, laparoscopically or via open myomectomy.

ENDOMETRIOSIS AND ADENOMYOSIS-

Endometriosis is a benign chronic gynaecological disorder that affects about 1.5% (population-based studies) to 15% (clinic based studies) of the population with internal reproduction organs, such as uteruses and ovaries. In this disorder, endometrium-like tissue grows outside the uterus in areas which may include the ovaries, fallopian tubes and peritoneum. The primary symptoms are pain, dysmenorrhoea, pelvic pain, dyschesia, dysuria and dyspareunia. Fatigue and bowel problems are common, but the disease can also occur without symptoms. Infertility is more frequent among persons with endometriosis (10% to 15%) than in the general population (9%).5 Endometriosis can affect several aspects of life including health, relationships and performance, and can have a negative impact on employment and education.

Common infections encountered by females 

Vaginal infections
Recurrent vaginal infections
Fungal infection
Vaginal itching, burning , pain
Infection of uterus , tubes  and cervix(Pelvic Inflammmatory disease)
Chronic cervicitis
Leucorrhea
Pap smear
Colposcopy