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FIVE important Gynaecological problems in Women

Gynecological problems are very common and they start with our menstrual cycles and may affect any organ of the female reproductive system. Irregular periods, heavy or thin bleeding, pain, itching or swelling in vaginal areas are few common symptoms which most of us do face at some point of time in our life but, we are shy of discussing such IMPORTANT ISSUES openly.

Though, the list of gynaecological problems is long, but understanding few most important of them that trap our women to save their lives from further anguish is required.

1.PCOD (Poly Cyst Ovarian Disease)

PCOD is the most common hormonal reproductive problem affecting 5-10% of women of childbearing age in which monthly ovulation may not occur and levels of male hormones (androgens) get elevated, making it difficult for a woman to conceive.

Symptoms:

  • Few or no menstrual periods or heavy, irregular bleeding.
  • Hair loss from the scalp and hair growth (hirsutism) on other body parts.
  • Acne and oily skin.
  • Infertility or repeated miscarriages.
  • Insulin resistance and obesity.
  • Depression or mood swings.

 Treatment:

  • Lifestyle changesdiet and exercise (for weight reduction), are considered first-line of treatment.
  • Medication— For women who want to become pregnant, fertility pills (oral anti-estrogen) or injections are given for ovulation. Oral contraceptives pills are given for regulating menstrual periods and reducing androgen hormone.
  • Surgery: A minor surgical procedure called laparoscopic ovarian drilling (LOD) may be helpful. A small cut in the lower abdomen is made and a thin microscope called a laparoscope is passed through the abdomen. The ovaries are then surgically treated using heat or a laser to destroy the tissue that’s producing androgens (male hormones). LOD correct the hormone imbalance and can restore the normal function of your ovaries. 

2. Endometriosis:

Endometrium is the tissue that normally lines the uterus or womb. When this tissue grows outside the uterus or to other areas in the body (like ovaries & fallopian tubes, vagina, cervix, bladder or rectum), it develops into lesions, nodules or growths called endometriosis.
Symptoms:

  • Very painful menstrual cramps.
  • Chronic lower back and pelvic pain.
  • Pain during or after intercourse.
  • Painful bowel movements or while urinating during menstrual periods.
  • Bleeding or spotting between menstrual periods.
  • Infertility occurs in 30-40% of women.
  • Stomach (digestive) problems like diarrhea, constipation, bloating, or nausea.

Treatment

  • Nonsteroidal antiinflammatory drugs (NSAIDS) and hormonal birth control pills help in relieving pain.
  • Hormone (progestins) Injectables and implantables (intrauterine device) are also effective in managing pain.
  • Gonadotropin releasing hormone agonists— These are medicines that work by causing a temporary menopause. The treatment causes the ovaries to stop producing estrogen, which causes the endometriosis implants to shrink. This treatment reduces pain in over 80 percent of women, including women with severe pain.
  • Surgery: For growth larger than 4-5 cm in the pelvic area, laproscopic surgery may be required to remove the mass. Removal of the uterus (Hysterectomy) or ovaries and fallopian tubes (salpingo-oophorectomy) might be recommended for those who continue to have severe symptoms and do not want to become pregnant in future.

3. Dysmenorrhea (Painful menstruation):

Normally, during menstruation, the uterus contracts but when it contracts too strongly, it can press against nearby blood vessels, cutting off the supply of oxygen to the muscle tissue of the uterus resulting into immense pain. It is the most common menstrual disorder and is estimated to occur in 20% to 90% of women of reproductive age.

It is mainly of two types viz: Primary dysmenorrhea that occurs in the absence of any identifiable pelvic disease. Secondary dysmenorrhea is due to disorder in the woman’s reproductive organs, mainly endometriosis.

Symptoms:

  • Severe pain and pressure in the abdomen, hips, lower back, and inner thighs.
  • Upset stomach and vomiting in severe cases.

Treatment

  • Non-steroidal anti-inflammatory drugs (NSAIDs) and analgesics are the most reliable and effective treatment for relieving dysmenorrhea.
  • Topical heating can give relief to the pain. 

4. Abnormal vaginal bleeding

This refers to the flow of blood from the vagina that occurs either at the wrong time (besides menstrual periods) during the month or in inappropriate amounts. It may have many possible causes and the assessment by the doctor may require information related to the following factors and symptoms:

  • Age: Young- pre-pubertal girl, woman of reproductive age or postmenopausal women.
  • Pregnancy status of the woman: Irregular bleeding may be a sign of very early pregnancy or bleeding during pregnancy may be associated with miscarriage, ectopic pregnancy, an abnormal location of the placenta, cervical infection or polyp and premature labor.
  • Pattern of bleeding: The duration too long (hypermenorrhea) or too short (hypomenorrhea), interval too frequent (polymenorrhea) or too seldom (oligomenorrhea) and amount of vaginal bleeding too much bleeding (menorrhagia) or too little volume (hypomenorrhea) may suggest what type of abnormality is responsible for the bleeding.
  • Vaginal bleeding may occur during or after intercourse due to injury, infection or due to tumors or polyps on the cervix or vaginal wall.

Treatment

  • Medications: If the cause is a precancerous change in the lining of the uterus, progesterone medications may be prescribed to reduce the buildup of precancerous uterine lining tissues.
  • A menopausal woman is offered an oral contraceptive to establish a more regular bleeding pattern.
  • In case of polyps or other benign growths, surgical removal is recommended.
  • In case of infection, antibiotics are necessary.
  • For uncontrolled bleeding, a surgical procedure called dilation and curettage (D&C) may be necessary.
  • Occasionally, a hysterectomy (uterus removal) may be done.

5. Fibroid Tumors

Fibroids are the most frequently diagnosed tumor (non-cancerous) that develop in the muscular wall of the uterus. They can range in size from very tiny (a quarter of an inch) to larger than a cantaloupe.

Most fibroids occur in women of reproductive age and are seldom seen in young women who have not begun to menstruate and usually stabilize or shrink during menopause.                       

Symptoms:

Some women never exhibit any symptoms nor have any problems associated with fibroids. Only 10 to 20 percent of women with fibroids exhibit following symptoms:

  • Heavy, prolonged menstrual periods, sometimes with clots; leading to anemia.
  • Pain in pelvic area, back and legs.
  • Pain during intercourse.
  • Frequent urge to urinate.
  • Constipation and bloating.
  • Abnormally enlarged abdomen.

Treatment

  • For women who experience occasional pelvic pain or discomfort, over-the counter anti-inflammatory or pain-reducing drugs are given.
  • Nonsurgical Uterine Fibroid Embolization: In this, a tiny slit in the groin is made and a catheter is inserted into the femoral artery and tiny particles of the size of grains of sand are released into the uterine arteries that supply blood to the fibroid tumor. This blocks the blood flow to the fibroid tumor and causes it to shrink and die.
  • Magnetic Resonance Guided Focused Ultrasound is a non-invasive outpatient, procedure that uses high intensity focused ultrasound waves to ablate (destroy) the fibroid tissue. MRI is used to see inside the body to deliver the treatment directly to the fibroid. High-intensity ultrasound energy that is directed to the fibroid heats up the tissue and destroys it. This method of tissue destruction is called thermal ablation.
  • Surgical Treatments for Fibroids: Gynecologists perform hysterectomy(uterus removal) and myomectomy (cutting out the fibroid and then stitching the uterus back) surgery.

In case you experience one or more of these warning signs on a regular basis, consult your gynaecologist without any delay.

Your health is important, please don’t ignore it!

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