• Overview
  • Why Chose Us
  • Treatments
  • Our Doctors

Overview:

Our world revolves around you right from the moment you walk into ABR Neuro Multi Speciality Hospitals The Department of Gynaecology provides our patients with various choices for personal gynaecologic care and Fertility services offers an easy-access approach to complete health care for women. Our gynaecologist performs many types of procedures to treat both common and rare gynaecologic conditions. We provide minimally invasive treatment whenever possible to reduce patient discomfort. Our extensive experience in vaginal and laparoscopic approaches, as well as reconstructive surgery, ensures the restoration of normal anatomy and function. The services available at our Gynaecology department are listed below:

  • Women’s Health
  • Pap Test
  • Abnormal Pap Smear & Cervical Dysplasia
  • Colposcopy
  • Polycystic Ovarian Syndrome (POCS)
  • Contraception
  • Menorrhagia
  • Fibroids
  • Endometriosis
  • Pelvic Inflammatory Disease
  • Menopause
  • Post-Menopausal Bleeding
  • Uterovaginal Prolapse
  • Miscarriage / Recurrent Miscarriages
  • Infertility

Why Chose Us:

ABR Neuro Multi Speciality Hospital is one of the best hospitals for Women Care in Hyderabad. We have the Best Gynecologists In Hyderabad, who have Good experience in the field of gynecology. They offer services such as:

  • Regulation of menstrual cycles
  • General gynecological care
  • Prevention, diagnosis, and treatment of sexually transmitted infections
  • Urinary infections and overactive bladder
  • Treatment of uterine fibroids, ovarian cysts, and other vaginal infections
  • Interstitial cystitis

We have the best obstetricians in Hyderabad who are well versed in the field of obstetrics, who are ably supported by their support staff and nurses. They provide treatment in areas such as:

  • Painless Normal Delivery
  • Cesarean section (C-section)
  • Tubal ligation and reversal of tubal sterilization
  • Hysterectomy
  • D&C
  • Endometrial ablation

ABR Hospitals for Women Care is one of the best hospitals for high- risk pregnancy in Hyderabad to help mothers and their babies to have the most comfortable and safe pregnancy as possible. Our doctor and their support staff are well equipped and trained to care for the wellbeing and safety of the mothers and babies throughout the pregnancy and delivery. We have personalized birthing suites to provide a comfortable and serene atmosphere for the mother and child. We provide excellent prenatal care and postnatal care including nutrition tips for breastfeeding with the help of our experienced doctors and skilled support staff. ABR Multi Speciality Hospitals is one of the Best Hospitals For Women’s health in Hyderabad as we educate, support and help in managing fertility issues from the preconception stage to pregnancy. Our doctors guide and counsel the patients and their family members in a detailed way so that there are no misconceptions or doubts in the patients’ minds.

Treatments:

ABR Hospitals is one of the best hospitals for Women Care in Hyderabad. We have the best gynaecologist & Infertility Specialist in Hyderabad, who have vast experience in the field of gynecology. We offer services such as:

  • General gynecological care
  • Prevention, diagnosis, and treatment of sexually transmitted infections
  • Regulation of menstrual cycles
  • Treatment of uterine fibroids, ovarian cysts, and other vaginal infections
  • Urinary infections and overactive bladder
  • Interstitial cystitis

Our gynecologists also do thorough and complete infertility investigations and assessments to help patients conceive.  Our doctors provide treatment such as ovarian induction, endometriosis and use of minimally invasive surgeries for tubal damage.


Some of the surgical procedures are

  • Myomectomy, Minimal Invasive Surgery/Laparoscopic Surgery, Hysterectomy, Colposcopy, etc
  • Laparoscopic Surgeries

Gynecology

ABR Neuro Multi Speciality Hospital is one of the Best Hospitals for the treatment of gynecological issues in Hyderabad.  Our doctors discuss the various Infertility treatment options available to the patients to make an informed choice on the type of treatment they want to follow.

Our experienced gynecologists are well versed in dealing with:

  • Uterine Issues like Adenomyosis, Asherman syndrome (intrauterine adhesions), Endometriosis, Uterine fibroids, Uterine polyps, Uterine prolapse, Urinary incontinence.
  • Menorrhagia (heavy menstrual bleeding), Menstrual cramps, Post-hysterectomy prolapse, etc
  • Menopause issues and post-menopausal bleeding
  • Ovarian Issues like Ovarian Cysts, Polycystic ovary syndrome (PCOS), Premature ovarian failure, etc
  • Cervical Issues like Cervical dysplasia, PAP Smear, etc

Pregnancy and Delivery:

Our Specialist at ABR Hospital will provide each patient with a personalized plan for pregnancy at every stage, with regular health check-ups, diet plans, medications, latest genetic screening tests, and diagnostic tests so that the patient will have an easy delivery without any kind of hassles.

ABR Neuro Multi Speciality hospital is one of the best hospitals for pregnancy and delivery in Hyderabad.

  • Painless Normal Delivery
  • Cesarean section (C-section)
  • Vaginal Delivery After C-Section
  • Instrumental Delivery
  • LSCS (c-section)
  • LSCS with Tubectomy

ABR Hospital provide lactation consultation for mothers to teach them how to feed their babies. They help women experiencing breastfeeding problems such as painful nursing, low milk production, poor attachment to the breast, which can be overcome by helping a mother to correct her baby’s position.

Our Doctors:



Women’s Health

Women are the caretakers of others and often they forget that they also have a life and a body to look after which later on leads to several health problems. A woman's body goes through many major changes throughout life.

Conditions related to the urinary tract include urinary incontinence and urinary tract infections. Urinary Incontinence, the inability to control urination, is more common in women than in men. Women are more prone to urinary tract infections than men because the female urethra is shorter. Reproductive conditions such as endometriosis and premenstrual dysmorphic disorder (PMDD) are confined to women

Women’s health refers to health problems related to female anatomy. Various conditions exist that are confined to women and some of them may be debilitating. Health problems that are unique in women include menstrual problems, pregnancy complications, childbirth complications, post-menopausal conditions, and breast cancer. Gestational diabetes is one of the most common conditions occurring during pregnancy.


Facts about Women’s health

  • As compared to men women are twice at risk to have a UTI
  • The risk of women’s health includes diseases like cancer, depression, CVD diseases, heart disease, stroke, and others.
  • As compared to men women are highly infected with an eating disorder
  • Women have different and unique risk factors
  • Women are easily and more likely to discover stress and depression
  • Women notice smell better
  • Women are at the highest risk of dying while giving birth

Steps towards a longer, simpler, and healthy life

  • Deal with stress According to the reports women are more likely to witness stress and depression earlier than men. A woman needs to deal properly with stress and come out of it. Half of the health complications come due to stress problems. Stress leads to high blood pressure, back pain, relationship problems, sleeping problems, and others. To avoid these things, practice meditation, yoga, or exercise.
  • Get moving It is widely suggested to do a bit of exercise every day. Even if you are not able to do a heavy exercise try investing yourself in a 30-minute workout session. Include Walking, jogging, dancing, or swimming and be consistent. Getting moving and exercising will help you improve your mental and bone health.
  • Adopt a healthy diet: Eating healthy and nourishing food is the foundation of a healthy lifestyle. Healthy and nutritious food provides the right amount of vitamins, minerals, calcium, and other important nutrients that are important for well-being.
  • Don’t avoid health risks Generally, women tend to avoid known health risks. One should never avoid the health risks or even symptoms related to them. Avoiding them can be very dangerous and can claim your life as well. If you feel major health issues with your body try contacting a doctor and take proper medication as provided.
  • Once and forever women can take charge of their health by being more active and aware of their body changes. Understanding the changes, their risk, conditions, symptoms, and proper medication can do a lot and save lives. For more information visit the Best Gynecology Hospital In Hyderabad. Till then stay safe, stay healthy.

Abnormal Pap Smear & Cervical Dysplasia

A Pap smear or Pap test or Cervical smear test is conducted as part of a woman’s routine health examination, after the age of 21 years. It is not a diagnostic test, but is a screening tool used to detect any abnormal cells in the cervix. The cervix is the lower part of the uterus that opens into the vagina.

Pap smears help in the early detection of any serious medical conditions, such as cervical cancer. An abnormal Pap smear may indicate the presence of infection or abnormal cells called dysplasia. Cervical dysplasia is abnormal cell growth on the surface of the cervix. An abnormal Pap smear may not necessarily indicate cancer. These results highlight the requirement of further testing to identify and confirm an underlying problem.


Causes of abnormal Pap smear

An abnormal pap smear may indicate any of the following, besides dysplasia (abnormal cells):

  • An infection or an inflammation
  • Trichomonas infection
  • HPV (Human Papilloma Virus) infection

Treatment

Following an abnormal Pap smear, the next step is further testing to confirm the cause of the abnormal cells. A repeat Pap smear or test for human papilloma virus (HPV), a major risk factor for cervical cancer, may also be recommended. Depending on the age of the patient and the type of abnormal cells, the doctor may recommend the following treatment options:

Cryosurgery: This procedure involves freezing the abnormal cells, which are then surgically removed. Cone biopsy or LEEP procedure: In this procedure, a small segment of cervical tissue including abnormal cells is removed by specially designed instruments for evaluation.


Pap Test:

What is a Pap test?

The Pap test, also called a Pap smear, checks for changes in the cells of your cervix. The cervix is the lower part of the uterus (womb) that opens into the vagina (birth canal). The Pap test can tell if you have an infection, abnormal (unhealthy) cervical cells, or cervical cancer. During a Pap smear, your doctor takes a sample of cells from your cervix to be tested and examined. A Pap test is safe with no medical risks and a relatively cheap test to undertake.


Why is a Pap test Performed?

A Pap test can save your life. It can find the earliest signs of cervical pre-cancer. If diagnosed early, the chance of preventing cervical cancer is very high. Treatment can prevent most cases of cervical cancer from developing.

Getting regular Pap tests is the best thing you can do to prevent cervical cancer. In fact, regular Pap tests have led to a major decline in the number of cervical cancer cases and deaths.


Do all Women need Pap Tests?

It is important for all women to have annual Pap tests, along with pelvic examinations, as part of their routine health care.

You need a Pap test if you are:

  • 21 years or older
  • Under 21 years old and have been sexually active for 3 years or more There is no age limit for the Pap test. Even women who have gone through menopause need regular Pap tests. Women aged 65 to 70 can talk to their doctor about stopping after at least 3 normal Pap tests and no abnormal results in the last 10 years

How to prepare for a Pap test?

Many things can cause wrong test results by washing away or hiding abnormal cells of the cervix.So, doctors suggest that for 2 days before the test you avoid:

  • Douching
  • Using tampons
  • Using vaginal creams, suppositories, and medicines
  • Using vaginal deodorant sprays or powders

Make sure to empty your bladder just before your examination for a more comfortable examination. Doctors suggest you to schedule a Pap test when you do not have your period. The best time to be tested is 10 to 20 days after the first day of your last period.


How is a Pap test done?

Your doctor can do a Pap test during a pelvic examination. It is a simple and quick test. While you lie on an examination table, the doctor puts an instrument, called a speculum, into your vagina, opening it to see the cervix.

The doctor performing the examination: Inserts a metal or plastic instrument called a speculum into the vagina.

  • A Pap test is painless but may be embarrassing.
  • Uses a small soft-bristled brush to get a sample of cells from the cervix.
  • Looks for lumps, sores, inflammation, or other abnormalities of the external genitals..
  • This is then sent to a laboratory for testing.

What do abnormal Pap test Results Mean?

Abnormal Pap test results usually do not mean you have cancer. Most often there is a small problem with the cervix. Some abnormal cells will turn into cancer but most of the time these unhealthy cells will go away on their own. By treating these unhealthy cells, almost all cases of cervical cancer can be prevented. If you have abnormal results, then consult with your health care provider about what they mean.

Although every effort is made to educate you on PAP TEST and take control, there will be specific information that will not be discussed. Talk to your doctor or health care provider about any concerns you have about PAP TEST.


Colposcopy:

What is colposcopy?

Colposcopy is a procedure in which a special magnifying instrument, called a colposcope, is used to look into the vagina and into the cervix. The colposcope gives an enlarged view of the outer portion of the cervix.


Why would a colposcopy be necessary?

Colposcopy is done when there are abnormal changes in the cells of the cervix, as seen on a Pap test. Further, it may be done to assess problems, such as genital warts on the cervix, inflammation of the cervix, benign growths or polyps, pain and bleeding.


What are the risks of colposcopy?

There may be a risk of infection when you have a colposcopy. Mild pain and cramping during the procedure and mild bleeding afterwards, are common. This most often happens when a biopsy is done. If there is heavy bleeding, fever, or severe pain after the procedure, contact gynaecologist immediately.


Polycystic Ovarian Syndrome (PCOS)

Polycystic ovarian syndrome (PCOS) is a common endocrinal disorder, as well as one of the common causes of infertility among women. It is characterized by an ovulation dysfunction to the normal growth and release of eggs from the ovaries. It is commonly seen in women of childbearing age. The hormonal imbalance results in enlarged ovaries containing several small cysts.


Causes

The exact cause of the polycystic ovarian syndrome is unknown. However, several factors, including genetics, have been implicated to play a role in the development of PCOS. Women with a family history of the polycystic ovarian syndrome are at a higher risk of developing this condition. Researchers have also found an association between excessive insulin production and the development of PCOS. The insulin hormone regulates blood sugar levels and any disorder affecting the insulin mechanism may result in excessive insulin secretion, which triggers androgen secretion from the ovaries.


Symptoms

The symptoms of polycystic ovarian syndrome vary from person to person and depend upon the nature and severity of the condition. Some of the symptoms of PCOS include infertility, absent or irregular menstrual cycle, and weight gain, usually around the waist. Abnormal facial and body hair, adult acne, and male pattern baldness or hair thinning may also develop due to excessive androgen secretion. In some patients, black or dark brown patches are seen around the skin of the neck, arm, breasts, or thighs.


Diagnosis

The diagnosis of the polycystic ovarian syndrome is based on the medical history, along with a physical and pelvic examination to evaluate the condition of the patient and help identify the underlying cause. Blood tests are conducted to determine the level of various hormones. Additional tests, such as a glucose tolerance test and evaluation of blood cholesterol may also be conducted in these patients. A pelvic ultrasound is performed to evaluate the appearance of the ovaries and the uterine lining. People residing in the parts of Hyderabad,Telangana can visit this ABR Nueiro Multi Speciality Hospitals which provides one of the best treatments related to PCOS.


Treatment

The treatment of polycystic ovarian syndrome is based on the symptoms and individual concerns, such as infertility, irregular menstrual cycle, acne, or obesity. Both medications and surgical treatment can be used for the management of PCOS. Infertility may be treated by fertility therapy with ovulation-inducing drugs. Clomiphene citrate, an oral anti-oestrogen, may be prescribed to patients. In some patients the doctor may add metformin to clomiphene, to help induce ovulation. In patients not responding to clomiphene and metformin, gonadotropins, namely, follicle-stimulating hormone (FSH) and luteinizing hormone (LH), can be administered by injection. Oral contraceptives may be prescribed for the management of irregular menstrual cycles. Oral contraceptives effectively reduce the level of the male hormone and are also effective in reducing excessive body hair growth and also minimize the risks of uterine cancer. Lifestyle modifications and anti-diabetic medications may be prescribed for the management or prevention of obesity and diabetes mellitus.

Surgery may be recommended in patients who do not respond to medications. Laparoscopic ovarian drilling, an inpatient surgical procedure, may be used to treat the condition and induce ovulation. Suggesting you the best if you live in Dubai and have a similar problem visit, Dr. Hima Bindu, the best female PCOS doctor in Hyderabad


Associated Risks

Patients with polycystic ovarian syndrome frequently develop other serious medical conditions, such as diabetes mellitus, cardiovascular diseases, pregnancy-induced high blood pressure, miscarriage, or premature delivery. These patients are also at risk of uterine cancer.


Menorrhagia

Menorrhagia is a condition characterized by abnormally heavy or prolonged menstrual bleeding, which may be disruptive to your normal activities. The most common symptoms of menorrhagia are:

  • Excessive menstrual flow that requires frequent changes, double sanitary protection, embarrassing accidents
  • Menstrual period that lasts longer than seven days
  • The passage of large blood clots
  • Fatigue, weakness, or shortness of breath (symptoms of anaemia secondary to the menorrhagia)

The cause of menorrhagia is not known in some cases; however, several conditions that may cause menorrhagia to include hormonal imbalance, dysfunction of the ovaries, uterine fibroids(non-cancerous (benign) tumours of the uterus), uterine polyps, adenomyosis (where endometrial glands are found in the muscular wall of the uterus), intrauterine devices (IUDs), cancer, inherited blood disorders, certain medications (anti-inflammatory medications and anticoagulants), and other medical conditions such as pelvic inflammatory disease (PID), thyroid problems, endometriosis, and liver or kidney disease.

Your doctor will do a pelvic examination and may recommend other tests or procedures such as a pelvic ultrasound scan or a biopsy of the lining of the womb if the woman is over 40 years of age. A biopsy is a technique of removing a piece of tissue from the inner lining of the uterus and is examined under a microscope. This is done to make sure that the cells are normal. Your doctor may also recommend an examination called a hysteroscopy, which involves placing a tiny telescope through your cervix to obtain a direct view of the lining of the womb.

Treatment options will depend on the cause of menorrhagia, the severity of menorrhagia, and the overall health of the patient. Some common treatments include:

  • Iron supplements may be started if your iron levels are low.
  • Non-steroidal anti-inflammatory drugs (NSAIDs) may help reduce menstrual blood flow as well as cramping.
  • Oral contraceptives may be given to help reduce bleeding and make menstrual cycles more regular.
  • Oral progesterone may be given to help correct hormonal imbalance and reduce menorrhagia.
  • Mirena, a type of intrauterine device which releases progesterone in the womb that thins the uterine lining and reduces the blood flow may be used. Surgery may be needed if medication therapy is not successful. The surgical procedures include
  •   Endometrial ablation: This is a procedure that permanently destroys the entire lining of your uterus (endometrium) resulting in little or no menstrual flow.
  •   Dilation and curettage (D&C): This is a procedure in which the cervix is dilated and the lining of the uterus is scraped to reduce menstrual bleeding. You may need additional D&C procedures if menorrhagia recurs.
  •   Hysteroscopy: This procedure involves the use of a telescope to view your uterine cavity and to remove abnormalities, such as a polyp, that may be causing heavy menstrual bleeding.
  •   Endometrial Resection: This is a surgical procedure that uses an electrosurgical wire loop to remove the lining of the uterus.
  •   Hysterectomy: Is surgical removal of the uterus. Surgical procedures should generally be deferred until your family is complete. Therefore, discuss with your doctor the treatment options if you plan to become pregnant in the future.

To know more about menorrhagia, visit ABR Multi Specility Hospitals,Hyderabad Dr. Hima Bindu the best Female Gynaecologist in Hyderabad.


Fibroids

Uterine fibroids are non-cancerous (benign) tumours, commonly seen in women of childbearing age. Fibroids are composed of muscle cells and other tissues. They develop in and around the wall of the uterus or womb. Based on their location within the uterus, uterine fibroids can be classified as:

  • Subserosal fibroids: Sited beneath the serosa (the membrane covering the outer surface of the uterus)
  • Submucosal fibroids: Sited inside the uterine cavity below the inside layer of the uterus
  • Intramural fibroids: Sited within the muscular wall of the uterus
  • Intracavitary fibroids: Sited inside the uterine cavity
  • Pedunculated fibroids: Develop on a stalk

Causes

The exact cause for the development of fibroids remains unknown, but some of the proposed causes include:

  • Genetic abnormalities
  • Alterations in expression of growth factor (protein involved in rate and extent of cell proliferation)
  • Abnormalities in the vascular system
  • Tissue response to injury
  • Family history of fibroids
  • Uterine infection
  • Consumption of alcohol
  • Elevated blood pressure
  • Hormonal imbalance during puberty

Symptoms

The majority of women with uterine fibroids may be asymptomatic. However the basic symptoms associated with fibroids include:

  • Heavy menstrual bleeding
  • Prolonged menstrual periods
  • Pelvic pressure or pain
  • Frequent urination
  • Constipation
  • Backache or leg pain
  • Difficulty in emptying your bladder

Diagnosis

The diagnosis of uterine fibroids involves a pelvic examination, followed by ultrasound evaluation. Other imaging techniques such as MRI scan and CT scan may also be employed.


Treatment

Different methods are being used for managing uterine fibroids. Surgery is considered the best modality of treatment. The common surgeries performed for the management of fibroids include:

  • Myomectomy or selective removal of the fibroids within the uterus
  • Destructive techniques that involve boring holes into the fibroids with a laser or freezing probes (cryosurgery)
  • Hysterectomy or removal of the uterus Non-surgical methods comprising of steroidal medication are also used to stabilise the oestrogen levels in the body.

Risks during pregnancy

Some studies indicate that the presence of uterine fibroids during pregnancy increases the risk of complications, such as first trimester bleeding, breech presentation, placental abruption, increased chance of caesarean section and problems during labour.


Endometriosis

Endometriosis is a common gynaecological problem affecting women of reproductive age. It occurs when the tissues of the uterus start growing on surfaces of other organs in the pelvis. Endometrium may grow on ovaries, fallopian tubes, outer surface of uterus, pelvic cavity lining, vagina, cervix, vulva, bladder or rectum. Patients may experience painful cramps in the lower abdomen, back or in the pelvis during menstruation, heavy menstrual bleeding, painful bowel movements or urination and infertility.

A defect in the immune system, hormonal imbalance, or as a complication of other surgeries, women may develop endometriosis. Your gynaecologist will ask you about your general health and symptoms and will perform a pelvic examination to feel for the presence of large cysts or scars. An ultrasound scan may also be performed to look for ovarian cysts. There are several treatment options available to minimise the pain, as well as control heavy bleeding.

symptoms associated with fibroids include:

  • Hormone Treatment: Hormone treatment is recommended if there is a small growth and mild pain. Hormonal preparations can be taken in the form of pills, shots, and nasal sprays. Birth control pills help to decrease the amount of menstrual bleeding.
  • Pain Medication: Over the counter pain relievers may be helpful for mild pain. Non-steroidal anti-inflammatory medications will be prescribed by your doctor in cases of severe pain.
  • Surgery: Surgery is an option for women having multiple lesions, severe pain, or fertility problems.
  • Laparoscopy: During this surgery, lesions and scar tissue are removed or burnt. This is a minimally invasive technique and does not harm the healthy tissue around the lesion.
  • Hysterectomy: It is a surgery that involves removal of the uterus. This procedure is done when there is severe damage to the uterus and only if the patient has completed her family.
  • Laparotomy or major abdominal surgery: This involves a larger cut in the abdomen which allows the doctor to reach and remove the endometrial lesion.

Pelvic Inflammatory Disease

Pelvic inflammatory disease (PID) is characterised by infection of the female reproductive organs, such as the uterus, fallopian tubes, and ovaries. It is mostly acquired through unsafe sexual practices and is one of the most serious consequences of sexually transmitted diseases (STD). PID can cause permanent damage to the female reproductive system, and is one of the leading causes of infertility.


Causes and risks

PID can occur when you are exposed to an STD, such as chlamydia or gonorrhoea. The cervix loses its ability to protect the internal organs from bacteria and the infection eventually spreads to your uterus, ovaries, and fallopian tubes. 90% of PID occurs as a result of untreated chlamydia and gonorrhoea. Sexual practices that involve multiple partners and unprotected sex increase your chances of acquiring STDs, which can in turn lead to PID.


Symptoms

PID can show minor symptoms or no symptoms at all (common with chlamydial infection). They can often vary, but may include:

  • Dull pain in your stomach and lower abdomen and pelvis
  • Green or yellow vaginal discharge, having a distinct and often unpleasant odour
  • Pain during urination
  • Irregular vaginal bleeding
  • Fever or chills
  • Nausea, vomiting or diarrhoea
  • Pain in the lower back
  • Painful intercourse
  • If you notice any of these symptoms, it is important to stop having intercourse and visit your doctor immediately, as prompt treatment is vital for PID.

Complications

Left untreated, PID can cause scarring and collection of abscesses (infected fluid) in the fallopian tubes. PID can also lead to infertility or ectopic pregnancy (implantation of embryo outside uterus). Scarring or damage can occur to other reproductive organs, which can cause chronic pelvic pain that can last for many months.


Diagnosis

Based on your signs and symptoms, your doctor may perform a pelvic examination and take swabs. Samples may be obtained from your cervix and vagina using a cotton swab, and sent to the laboratory to identify the bacteria causing the infection.

Your doctor may also recommend the following tests to confirm and determine the extent of your infection.

  • Blood tests, to analyse the infection
  • Pelvic ultrasound
  • Endometrial biopsy
  • Laparoscopy, to examine your pelvic organs

Treatment

Confirmation of PID will be immediately followed by treatment. You will be started on oral antibiotic medications for mild cases of PID. For more severe cases, you may be treated on a combination of oral and intravenous medications, or hospitalised for more aggressive management. It is important that your partner also gets treated, even if he does not have any symptoms, in order to prevent future re-infections.

If antibiotics fail to clear the infection, and if the infection forms abscesses in your uterus or ovaries, you may be recommended to undergo a hysterectomy (removal of the uterus) or an oophorectomy (removal of ovaries).

When your infection, abscess, or inflammation has cleared, but you are still experiencing chronic pelvic pain, you may be recommended to undergo nerve ablation surgery, where the nerves that provide sensation to your pelvic organs are surgically removed or destroyed.


Menopause

Every woman goes through several changes in the way her body functions, which marks different stages in her life. With puberty, starts the menstrual cycle, where certain hormones control the monthly release of the egg and preparation for pregnancy. The cessation of menstruation and the fertility of women is known as menopause, and occurs 6 months after your last menstrual period, when you are in your 40s or 50s. Some women can experience menopause before their 40s, and the condition is known as premature menopause.


Symptoms

Menopause can be characterised by physical and emotional changes. Approaching the time of your menopause (perimenopause), you may experience irregular menses, dryness of the vagina, sagging of the breasts, dry skin, thinning hair, slow metabolism, weight gain, hot flushes, night sweats, problems with sleeping, and mood changes.


Causes

Menopause is a natural process that takes place in every woman’s life as you reach your early 40’s or 50’s. The production of the hormones by your ovaries to regulate your menstrual cycle, namely oestrogen and progesterone, start to decrease. Eventually, your ovaries will stop producing eggs. This will make you experience changes in your menstrual pattern and bring an end to your periods.

There are some factors that can induce menopause. These include the following:

  • Cancer treatment: Chemotherapy (treatment with chemical agents) and radiotherapy (treatment by exposure to radiation) can cause menopause symptoms, and a temporary or permanent stop to your menstruation.
  • Failure of ovaries: Autoimmune diseases or genetic factors can cause your ovaries to produce less than normal amounts of reproductive hormones. This is known as primary ovarian insufficiency, and can lead to premature menopause.
  • Surgeries: Surgeries such as hysterectomy and bilateral oophorectomy that involve the removal of your uterus and both ovaries, will immediately stop menstruation.

Complications

Some of the possible complications associated with menopause include the following:

  • Your risk for heart and blood vessel (cardiovascular) diseases increases with the decrease in oestrogen production.
  • Your bone density may decrease, making them brittle and leading to a condition known as osteoporosis. This can make you more prone to fractures.
  • Your vaginal and urethral tissues will begin to lose their elasticity, and you may experience the sudden urge to urinate, or may lose control over your bladder (urge incontinence or stress incontinence). You may also become more prone to urinary tract infections.
  • The loss of moisture and elasticity of your vagina can cause discomfort during intercourse, and can affect your sexual desire (libido).
  • As the rate of your metabolism slows down, you may start gaining weight.

Diagnosis

Your doctor can identify your transition to menopause with your signs and symptoms. To confirm the diagnosis, your doctor may order blood tests to check your levels of follicle-stimulating hormone (FSH) and oestrogen (oestradiol), as a change in the level of these hormones can indicate menopause.


Treatment

Menopause itself needs no treatment, but treatment may be required to control its signs and symptoms. Your doctor will discuss the risks and benefits and may recommend any of the following, depending on your condition:

  • Hormone replacement therapy: Your doctor may recommend treatment with hormones including oestrogen and/or progesterone for your hot flushes and bone loss. It may also help prevent cardiovascular problems if started within five years of menopause.
  • Vaginal oestrogen: Small doses of oestrogen in the form of cream, pills, or rings can help you manage vaginal dryness, urinary symptoms and discomfort during intercourse.
  • Antidepressants: Low-dose antidepressants can help you manage hot flushes when hormone replacement therapy is not advisable for you, and will also help improve your mood.
  • Medication treatment: You may also be prescribed medications to reduce your bone loss and risk for fractures.

Lifestyle Remedies/Dietary Supplements

Some of these lifestyle remedies can also help you reduce or prevent the symptoms of menopause.

Cool off hot flushes by drinking cold water or staying in a cool room. Identify factors that trigger your hot flushes, like hot beverages, alcohol, caffeine and spicy foods, and try to avoid them.

Use water-based vaginal lubricants to help you with vaginal dryness and discomfort.

Reduce stress, get adequate sleep, eat healthy, stay active and don’t smoke.

Exercise regularly. Certain exercises called Kegel exercises can help you strengthen your pelvic floor muscles and improve urinary incontinence.


Conclusion

Menopause is an unavoidable phase in every woman’s life. Its signs and symptoms can be often disturbing, but it is important to understand your body and learn ways to cope with your difficulties. There are various options available to successfully manage your distress, and your doctor will be the right person to guide you through.


Post-menopausal bleeding

Bleeding after menopause, also known as post-menopausal bleeding (PMB), is a condition characterised by vaginal bleeding after 12 months of menopause. PMB is not pertinent to young women having amenorrhoea (absence of menstrual periods) due to anorexia nervosa or having a pregnancy followed by lactation. PMB may be related to those young women who are suffering from premature ovarian failure or premature menopause.

Menopause is a natural biological process resulting in a permanent cessation of menstruation. Menopause usually occurs in women during the fifth decade of their life. Menopause is confirmed by an absence of menstrual periods for 12 months consecutively.

In most cases, PMB is harmless, but sometimes it may be secondary to an underlying medical disorder. Therefore, bleeding after menopause should be carefully investigated.


Causes

The common causes of post-menopausal bleeding include:

  • Thinning of the tissues lining the uterus (endometrial atrophy) or vagina (vaginal atrophy)
  • Cervical and endometrial polyps
  • Infection and inflammation of the uterine lining (endometritis)
  • Endometrial hyperplasia (thickening)
  • Medications such as hormone replacement therapy
  • Cancer of the uterus, including endometrial cancer and uterine sarcoma
  • Cancer of the cervix or vagina
  • Non-gynaecological causes, such as pelvic trauma or bleeding disorder
  • Bleeding from the urinary tract or rectum

Determining the cause of postmenopausal bleeding

The cause of PMB can be determined by physical examination, medical history, and additional laboratory tests. The common tests that are employed are as follow:

Transvaginal ultrasound: A specially designed imaging device is inserted through the vagina to view the pelvic organs and to identify any abnormalities. Endometrial biopsy: This procedure involves insertion of a thin tube inside the uterus for withdrawing the samples of uterine lining, for laboratory analysis. Hysteroscopy: This procedure involves examination of the uterus through an instrument with a small camera and a light source. D&C (dilation and curettage): This procedure involves removal of tissues from the uterine lining, which are sent for laboratory analysis.


Treatment

Treatment of the PMB depends on the underlying cause of bleeding. Management of some of the common causes of PMB is as follow:

  • Polyps: They are surgically removed
  • Endometrial atrophy: Treated with medications
  • Endometrial hyperplasia: Treated with medications and/or thickened areas of the endometrium are surgically removed
  • Endometrial cancer: Treatment involves total hysterectomy i.e. surgical removal of the uterus, cervix and ovaries. In some cases, nearby lymph nodes, and part of the vagina may also be removed.
  • The treatment of advanced endometrial cancer may include hormone therapy, chemotherapy, and radiation therapy. Early detection and treatment of the cancer can result in full recovery.

Uterovaginal Prolapse

A prolapse is a medical condition where an organ or tissue falls down or slips from its normal position. A pelvic organ prolapse is a condition that occurs when the structures, such as the uterus, rectum, bladder, urethra, small bowel, or the vagina itself, falls out from their normal position.

Utero-vaginal prolapse is a downward movement of the uterus and/or vagina. The main cause of the prolapse is weakness in the supporting tissues of the uterus and vagina. The common factors, such as frequent lifting of heavy objects, chronic cough, severe constipation, menopause, childbirth, and pregnancy may increase your risk of developing a utero-vaginal prolapse.


Symptoms

A woman with a mild prolapse may not experience any symptoms. However, women with more severe forms of prolapse may experience:

  • A dragging sensation in the lower abdomen or pelvis
  • An uncomfortable feeling of fullness in the vagina
  • Low back pain
  • Difficulty in urinating and emptying the bowel
  • Urinary problems, such as urine leakage or urine retention
  • Vaginal bleeding or discharge

Diagnosis

Your doctor will diagnose the condition by taking a detailed history and performing a physical examination. During the examination, you may be asked to cough or bear down. The doctor may also perform computerised testing of the bladder to test for urinary leakage.


Treatment

If the symptoms are mild, non-surgical treatment options, such as medications, pelvic floor exercises, vaginal pessary (a device that is inserted into the vagina to support the pelvic floor), oestrogen containing vaginal cream, and lifestyle changes, may be helpful.


Complications

If left untreated, severe cases of utero-vaginal prolapse can cause ulceration and infection of the cervix and vaginal walls, urinary tract infections, lower tract bleeding, thickening of the skin of the cervix, urinary obstruction, and worsening of the prolapse.


Prevention

Although utero-vaginal prolapse is not always preventable, there are certain measures that can be taken to help reduce the risk of developing utero-vaginal prolapse or prevent it from getting worse. These include:

  • Perform Kegel exercises to strengthen your pelvic floor muscles, especially during pregnancy and after childbirth
  • Do not bear down when giving birth until your cervix is completely dilated
  • Avoid heavy lifting, prolonged standing, and chronic coughing
  • Take hormone replacement therapy after the menopause
  • Perform pelvic floor exercises on a regular basis
  • Avoid constipation and straining with bowel movements, after delivery

Miscarriage / Recurrent Miscarriages

Miscarriage is the natural loss of a baby in its mother’s womb before 24 weeks and may happen even without a woman is aware that she is pregnant. This usually occurs in the first trimester (13 weeks) of pregnancy. Symptoms include vaginal spotting or bleeding, abdominal pain or cramping, and fluid or tissue passing from the vagina. If you have any of these symptoms, you should call your doctor, who may do an ultrasound exam and a pelvic exam to confirm the miscarriage.

Most miscarriages are caused due to genetic abnormalities that occur by chance and are not related to the mother’s or father’s health. Other causes include infection, certain medications, hormonal effects, structural abnormality of the uterus, and disease conditions such as severe kidney disease, congenital heart disease, and uncontrolled diabetes.

Recurrent or consecutive miscarriages - These may be due to genetic conditions, maternal ill health, and a variety of other conditions that may need further specialized investigations, that will be discussed with you by Dr. Hima Bindu a specialist for miscarriage in Hyderabad.


Infertility

Infertility is a condition where the couple is unable to conceive after 12 months of regular sexual relationship without birth control. There are two kinds of infertility - primary and secondary: Primary infertility means that the couple has never conceived. Secondary infertility means that the couple has experienced a pregnancy before and failed to conceive later. A number of people face these problems but are embarrassed or hesitant to seek help. To understand infertility, we need to understand the process of fertilization.


When to get help?

As suggested by Dr. Hima Bindu infertility specialist in Hyderabad. You may have reason to be concerned if you have been trying to get pregnant for at least one year and:

  • You are in your late 30s and have been trying to get pregnant for six months or longer
  •  Your menstrual cycles are either irregular or absent
  • You have had multiple miscarriages
  • You have painful periods and pain at intercourse
  • You have a known history of fertility problems
  • You have been treated for cancer with drugs and radiation
  • You have a history of pelvic inflammatory disease or endometriosis

What are the causes?

Some of the causes may include:

  • Problems with ovulation: Certain conditions, like polycystic ovarian syndrome PCOS specialist in Hyderabad  (ovaries secrete excessive amounts of male hormone testosterone) and hyperprolactinemia (produce high amounts of prolactin, a hormone that induces the production of breast milk), can prevent your ovaries from releasing eggs.
  • Damaged fallopian tubes: Fallopian tubes carry the eggs from the ovaries to the uterus. Any damage to them can affect the fertilization of the egg by the sperm. Pelvic surgeries and infections can cause the formation of scar tissue that can damage your fallopian tubes.
  • Abnormalities of the cervix and uterus: Abnormal mucus production in the cervix, problems with the cervical opening, abnormal shape, and presence of benign growths in the uterus can all contribute to infertility.
  • Premature menopause: Mostly caused by a condition known as primary ovarian insufficiency, premature menopause occurs when menstruation stops before the age of 40. The exact cause of this condition is unknown, though various treatments for cancer and abnormalities with the immune system have been known to contribute to it.
  • Adhesions: Bands of scar tissue can form in the pelvis after an infection or surgery.
  • Other medical conditions: Diabetes, endometriosis, thyroid disorders, sickle cell disease, or kidney diseases can affect the fertility of a woman.
  • Medications: Certain medications have been known to cause temporary infertility. Stoppage of those medications can restore fertility in most cases.

Who is at risk?

Your fertility decreases with age. You are at greater risk if you smoke, consume excess alcohol, or are overweight, obese, or underweight.


Diagnosis

Female infertility can be confirmed with the following tests:

  • Blood tests measure your hormone levels and determine if you are ovulating.
  • Biopsies may be obtained to evaluate the inner lining of your uterus.
  • Ovarian reserve testing may be performed in order to determine the number and quality of eggs ready for ovulation.
  • Imaging studies such as a pelvic ultrasound or hysterosonography may be performed to obtain a detailed view of your fallopian tubes and uterus.
  • Hysterosalpingography involves obtaining an x-ray image after injecting contrast material into your cervix which travels up to your fallopian tubes. This can help identify any blockages in your fallopian tubes.
  • Laparoscopic evaluation involves inserting a thin tube fitted with a camera through an incision in your abdomen, in order to detect any abnormalities in your reproductive organs, such as the ovaries, uterus, and fallopian tubes.

How is infertility treated?

Your doctor will suggest a treatment suitable for your problem. Fertility drugs may be recommended to stimulate and regulate ovulation, in women who are infertile due to ovarian disorders. You could also be chosen for assisted insemination, where your husband’s sperm is collected, concentrated, and placed directly into your uterus when your ovary releases eggs to be fertilized. This procedure is also known as intrauterine insemination (IUI) and can be in tandem with your normal menstrual cycle or fertility drugs. Apart from these, problems with your uterus, such as intrauterine polyps or scar tissue, can be treated with surgery.

In vitro fertilisation (IVF) is a type of assisted reproductive technique, which involves collecting multiple mature eggs from a woman and fertilising them with sperm outside the body, in the lab. Once fertilised, the embryos are implanted into the uterus within three to five days.

Some of the other techniques used in IVF include intracytoplasmic sperm injection (a single healthy sperm cell is directly injected into a mature egg), assisted hatching (the outer covering of the embryo is removed to facilitate embryo implantation into the uterus), and using donor eggs or sperm. Gestational surrogates may also be considered for women for whom pregnancy poses high health risks, or for those who have a non-functional or absent uterus.


Conclusion

fertility can be of a variety of causes, and the treatment may differ accordingly. Dealing with infertility can be difficult and can be stressful and emotional, but there is hope – about two-thirds of the couples treated for infertility conceive successfully. Your doctor will be the best person to address your concerns.

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