Contraception
How many times in a month can one take the EC emergency contraception
EC can be taken as required. It is safe and effective but one must remember that it is an option for emergency. It cannot replace regular contraception methods. If you require EC very often then in that case you should take regular contraceptives. Do oral contraceptives cause wt gain?
No they do not cause any weight gain. This is a myth and common cause of discontinuation of the pill. The progesterone component amy cause a little water retention prior to the period which happens even normally. This water is usually then shed after the period. Will I get pregnant when I stop the pill?
Yes you will conceive when you stop the pills. The pills suppress ovulation only when they are consumed. As soon as you stop the ovary resumes its function in one or two cycles. Very occasionally it may take up to 3 – 4 cycles. Back to Top Abortion
Are the tablets for abortion safe?
Yes they are safe and effective. They have 95 percent success rate up to seven weeks of pregnancy. In India they are licensed for use up to 7 weeks. Is it mandatory to do USG i.e. ultrasound before taking the tablets
No it is not mandatory but most doctors would prefer to do it if the facility is available and affordable. Will these tablets affect fertility in the future?
No these tablets do not have any effect on the fertility. Back to Top
PCOS
Is it advisable to take hormonal treatment for the management of acne and hirsutism.
Acne and hirsutism may be part of the PCOS. Which is a metabolic disorder having hyperandrogenemia i.e. increased androgens as one of its features. Combined oral contraceptives are frequently used for the treatment of PCOS and are very effective in reducing androgen levels in the circulation. When taken for long term i.e. 12 – 24 months they can bring about a change in acne and hirsutism. Back to Top
Pregnancy
Is it important to see the Doctor even before one conceives?
Yes it is advisable to consult the doctor when you start to plan a pregnancy.
The doctor can take a detailed history and identify issues which need attention before you get pregnant. Eg – try to get optimum weight with regular diet and exercise, stop smoking, control diabetes, and detect thyroid problems if any. The doctor will advise you to take folic acid supplements of 400 mcg daily as there is enough scientific evidence to support the fact that folic acid supplementation reduces the risk of neural tube defects.
Hemoglobin levels can be assessed and if required iron and multivitamins can be given. Immunity to certain viral infections such as hepatitis and rubella can be detected and immunization can be done if required. When one is pregnant is it safe to
Wear high heels – it is advisable to wear flat shoes.
Swim – yes it is safe to do so as long as all is well in the pregnancy.
Drink coffee – yes only upto 300 mg per day which equals to about two cups per day
Drink alcohol – it is advisable to avoid alcohol not only during pregnancy but also when one is trying to get pregnant.
Do fasts – It is advisable to avoid fasting but modifications which allow consumption of liquids and fruits and certain food items can be done if very essential. Can labor be painless?
Yes very much.
During labor one can opt for epidural analgesia i.e. an analgesic is given into the epidural space in the back through a catheter. This does not interfere with the contractions but numbs the lady to the pain. If due to any reason a caesarean section is required then it can be done under the same analgesia. It is a common myth that the needle in the back will cause long term back pain. But this is not so. The back pain after delivery can result due to a number of reasons such as damage to the nerves due to prolonged second stage or due to lack of calcium. Is it possible to have a vaginal delivery after a caesarean section?
Yes it is possible. There are a number of factors that will influence the decision of a vaginal delivery or caesarean section. If there are certain additional factors such as transverse lie, breech presentation, big baby, placenta previa, or a previous vertical scar then in that case a planned repeat caesarean section will be required. If the pregnancy has been uneventful, the foetus is of reasonable size,there are no maternal complications and labour starts spontaneously then the doctor may attempt a vaginal delivery under strict monitoring of the labour. Back to Top Fibroids
Do all fibroids need to be removed?
No. fibroids need to be removed only if they are very large or in case they are causing symptoms such as heavy bleeding not responding to medical treatment. Many asymptomatic fibroids can be left alone. Is fibroid a cancerous growth?
No. Fibroids are benign growths. Back to Top Stress Urinary Incontinence
I leak small amount of urine every time I cough or sneeze. This may also happen sometimes when I laugh loudly. Is there a solution for this problem?
YES. This is called Stress Urinary Incontinence (SUI). When the pressure in the tummy increases (as in coughing, sneezing & laughing), then the bladder neck moves down through the pelvic floor and small amounts of urine may leak. This diagnosis is confirmed on clinical examination. Mild degree of SUI can be treated to some extent with medicines. Some women require surgical procedure. There is a wide range of options in surgery now. Stitches or a tape is inserted at the level of the bladder neck either through the abdomen or vagina. Fibrosis and scarring follows which prevent SUI. Back to Top Prolapse
My private parts descend down especially when I strain for a bowel movement. What should I do?
This is called as prolapse. The Uterus and Cervix, anterior and posterior vaginal wall may descend through the vagina and the introitus. You are advised to seek a gynecological opinion.
Depending on the degree of prolapse there are several management options.
Kegel’s exercise to strengthen the pelvic floor is useful. If the descent is severe, then there are two options.
• Uterus may be removed and the vault is repaired & fixed.
• Uterus is conserved and the supports of the uterus are strengthened. Back to Top Menopause
I am now 50 years of age and I am not getting my periods since almost 1 ½ year. What should I do?
You are now menopausal. If you have any symptoms such as suddenly feeling hot especially at night, dryness in vagina, mood swings then you should seek a doctor’s opinion. Various treatment options are available.
Longevity and Quality of life, both are important and this is the time to assess your status. You should do a routine screening of your health.
Certain tests that the gynecologist would advise are:
• Pap smear
• Mammography
• Bone densitometry.
• Ultrasound of the pelvis. You will also benefit from certain life style modifications, dietary supplements such as soyabean and calcium. Back to Top Osteoporosis
My mother had a fracture after a fall. This was due to Osteoporosis. What precaution can I take?
Dexa Scan for bone mineral density is the definite way of diagnosis for Osteoporosis. Regular exercise, life style changes (such as stopping smoking) can help prevent Osteoporosis. Adequate dietary intake of calcium and vitamin D is important and should be implemented from childhood. Biphosphonates are used for prevention and treatment of Osteoporosis. They have proved to be effective in increasing bone mineral density and preventing fractures. They should be taken under medical supervision.
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