Frequently Asked Questions
I am diagnosed with PCOD? What is it? What do I do to correct it?
Polycystic ovarian disease/ syndrome is a state of hormonal imbalance wherein the male hormones in a woman dominate, leading to complaints like scanty or irregular periods, increased facial or truncal hair, hoarse voice, infertility, etc. You will need to visit a gynecologist to undergo certain blood and sonography tests which help understand the problem better. It can lead to health disorders in the future like Diabetes, metabolic syndrome, hypertension, ovarian or uterus cancers, if not corrected early. It’s a lifestyle disorder due to faulty eating habits, lack of exercise, sedentary lifestyle, etc. and hence treatment involves adopting healthy lifestyles. Correcting your periods with medicines, facial hair treatments, infertility treatments will only temporarily correct your problems and won’t eliminate the disease from its roots, for which you will need to concentrate on weight loss, healthy diet & lifestyle.
What is the ideal diet for pregnancy?
Pregnancy demands eating a little more than usual, but definitely not double the amount of food. You can consume any wholesome, well-cooked, home-made food, in moderation. Never forget to include a balance of various pulses, vegetables, fruits, and dairy products, apart from the routine cereals. Have frequent meals in small quantities, rather than large meals with long gaps. Ensure you add adequate proteins to the diet, especially if you are a vegetarian. Sugary foods, extra salt, and processed foods are a strict no-no. Get a proper diet charted by a dietician to help you know your body requirements. A balanced diet and an active body can help you & your baby stay strong and healthy.
Is repeated sonography necessary in pregnancy?
Sonography is an excellent tool to know the details within the womb. Since it consists of transmitted sound waves, it is absolutely safe to undergo even repeated tests, if the need be. An ultrasound scan early in pregnancy helps establish that pregnancy is not ectopic, the accuracy of the expected delivery date is high, and helps to know whether there is any deviation from normal like missed abortion, molar, or twin pregnancy. Scans in the 1st & 2nd trimester with blood tests (dual or triple marker) help identify anomalies if any, with almost 90% accuracy. Repeat scans are necessary for twin/triplet pregnancy to see if their growth is concordant, and if not, then your gynecologist can monitor further & intervene early if the need be. Scans in the last trimester help know the amount of liquor, growth retardation in the fetus if any, and a color doppler can further suggest if blood supply to the fetus seems normal or not. Since it’s an excellent aid to the gynaec to come to helpful decisions, always co-operate her/his decision for such a harmless investigation as sonography.
I have excessive vaginal discharge. Should I be worried?
Vaginal discharge is common in women at some point of time in life. Regular changes in its consistency and amount could indicate a healthy hormonal balance. Only in cases where it is foul-smelling & associated with itching in the genitals, it could be worrisome.
A routine gynaec checkup can confirm the type of infection if any, and treated accordingly. Most of these infections could be sexually transmitted, hence treatment of partners is equally important.
Fungal infection due to candidiasis can cause white curd-like discharge with redness or swelling of vulva or vagina & stinging or burning while passing urine. It can also occur in pregnancy or due to antibiotic overuse or in certain immunity disorders. Treatment is the use of antifungal medications and pessaries.
What cancer symptoms do I look for?
Cervical cancer may exhibit symptoms at too late a stage, hence regular gynaec check-ups and PAP smear testing can help detect early or precancerous stages.
Symptoms to be looked for are:
- Bleeding/spotting in between two menstrual cycles or post-coital bleeding/spotting
- Postmenopausal bleeding or even spotting(can also suggest uterine cancer)
- Unusual foul-smelling or heavy vaginal discharge with mucus
- Pelvic pain/painful urination/painful sex
- Sudden weight loss
Ovarian cancer may exhibit very subtle symptoms even in later stages, but awareness and regular checkups are the best keys to prevent them. Symptoms to be watched for are:
- Bloating or mild nagging abdominal pain
- Difficulty in eating or quickly feeling full while eating
- Loss of appetite
- Change in bowel movements
- Sudden weight loss/gain
- Frequent urge to urinate
- Persistent fatigue
- Increased abdominal size
Breast cancer: symptoms that could raise an alarm are:
- Lump/ swelling in the breast
- Change in size or shape
- Puckering or dimpling over breast, rash
- Pulled in nipples, nipple discharge, or bleeding
- Swelling/lump in the armpit or at the collarbone
Some symptoms may mimic even healthy changes in the breast but contact your doctor immediately in case you find any of the above changes while doing the self-breast examination
Apart from routine gynaec cancers, a lady needs to be aware of other cancer symptoms too like blood in urine or stools, changed bowel habits, abnormal bleeding from any site on the body, persistent pain in the back or bones, loss of appetite, or unexplained weight loss. Women with a family history of cancers need to be alert about any such changes, at the earliest.
I have an ovarian cyst. Should I be worried?
Ovarian cysts are fluid or tissue filled pouches that are common throughout the childbearing age in a woman’s life. Most of them are benign and may go away on their own or may need medications and watchful waiting with serial ultrasound follow-ups.
Certain conditions like a dermoid cyst, complex cysts, or endometriotic cysts usually persist & may need further investigations to rule out cancer and may eventually need surgery. Certain blood tests like CA 125 & other tumor markers & CT scan/MRI may help in diagnosis. Surgery mostly involves removal of the cyst only(cystectomy) or entire ovary(oophorectomy).
What do I avoid eating in pregnancy?
Excess coffee (more than two cups a day), raw or undercooked meat or fish, packaged or processed foods, excess salt & sugar in daily meals should be strictly avoided.
Can I exercise during pregnancy?
If you are already on an exercise plan while you get pregnant, you can continue to do so. Avoid strenuous or weightlifting exercises. Yoga, pranayama, and light exercises with a brisk walk are allowed but do get a nod from your gynecologist beforehand. Know your limits and don’t indulge in exercises that may lead to a fall or injury. Avoid exercises in 1st trimester preferably. Always ensure you are well hydrated before any workout regime.
When does a baby begin movements in the womb?
A fetus is active inside the uterus right from the 2nd month as soon as it has limb buds. However, a would-be-mother can perceive it only by 18-22 weeks of pregnancy. Some overweight or obese women may find it difficult to perceive even after completing 6 months due to abdominal fat or excess fluid around the baby. Once you enter 3rd trimester, ensure to keep a daily fetal kick count. It means that daily, the fetus should have at least 10 movements in a day or 2-3 after each meal. Any decrease in the perception of fetal movements shouldn’t be taken lightly and your gynecologist appointment should be sought for asap.
How to maintain hygiene of the genitals?
Use running tap water to wash the vaginal area. The use of excessively hot or cold water can cause further harm.
Use of soaps, however, claimed as gentle, in the vagina, is a strict no-no. Soaps claiming to be antibacterial or health-promoting, cause more harm than good.
No antiseptics, douches, sprays, or talcum powders to be used at the genitals. A mild vaginal wash may be allowed.
Avoid the use of tight or synthetic undergarments.
Prefer to use condoms to prevent sexually transmitted diseases even though you are using any other form of contraception.
I had unprotected sex. What do I do?
To prevent pregnancy after an act of unprotected sexual intercourse, emergency contraception means are to be used.
These methods are to be used as soon as possible but can be effective even up to 5 days of the act. They are most effective if used within the 1st 72 hours, and can expect 75-90% success.
Various means to be used after the advice of your gynaec are:
- Copper IUD – Copper T can be inserted after such an act, to prevent implantation of the embryo. It is effective in 99% of cases.
- Emergency contraceptive pills containing levonorgestrel(LNG) or combined pills of Ethinyl estradiol with LNG can be safely used. They do not harm future fertility but repeated usage may lead to menstrual irregularities.
Emergency contraception can be used by women or girls at risk of unwanted pregnancy
- When no contraceptive means have been used
- Due to sexual assault
- When the failure of contraception is expected as in condom tear during the act, missed pills or lost/expelled copper T.
Facts to remember: Emergency contraception, as the name suggests, is only for emergency situations and not for regular use. The best way is to use regular contraception and to understand the correct use of various contraceptive methods available.
What are fibroids? Will they harm me?
Fibroids are benign over-growth (not cancers) of the muscle mass of the uterus. They can occur in women of any age group, in varying numbers and sizes.
Symptoms noted are heavy & painful menstruation, pain in the lower abdomen or lower back, pressure symptoms like frequent urination or constipation, infertility, pregnancy complications like miscarriage or premature delivery(if large). Many times they are asymptomatic and go unnoticed until an incidental diagnosis on sonography.
In case you have any of the above symptoms, you will need to undergo treatment for fibroids. If asymptomatic, they can be left alone, as chances of fibroids turning cancerous are extremely rare. Treatment for fibroids also varies as per the symptoms, per se there is no treatment to prevent their growth/recurrence. Fibroids usually shrink after menopause.
Dr. Nupura Kashikar (Kotwal)
MS, DNB (obgy), FMAS
Consultant Obstetrician & Gynaecologist
Laparoscopic surgeon & Infertility specialist