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Reproductive Health Concerns in Females

 

MENSTRUAL PROBLEMS

 What When should menstrual cycle be considered abnormal and investigated?

Cycle length less than 21 days and more than 35 days is said to be abnormal which should be investigated. Also if the female is suffering from any other health problems like excessive weight/obesity then a doctor should be consulted for management.

 

 What What is a painful menstrual period?

Painful menstrual period is a fairly common thing. It is by crampy lower abdominal pain. A woman may feel sharp pain that comes and goes, or have dull, aching pain. Painful menstrual periods may also cause back pain. The pain may begin several days before or just at the start of your period. It generally subsides as menstrual bleeding tapers off.

 

 What How can painful menstrual periods be managed at home?

The following steps may allow you to avoid prescription medications:
(i) Apply a heating pad to your lower abdomen (below the umblicus). Be careful NOT to fall asleep with it on.
(ii) Take warm showers or baths.
(iii) Drink warm beverages.
(iv) Do light circular massage with your fingertips around your lower abdomen.
(v) Walk or exercise regularly, including pelvic rocking exercises.
(vi) Follow a diet rich in complex carbohydrates such as whole grains, fruits, and vegetables, but low in salt, sugar, alcohol, and caffeine. (vii) Eat light but frequent meals.
(viii) Practice relaxation techniques like meditation or yoga.
(ix) Keep your legs elevated while lying down. You can also lie on your side with knees bent.
(x) Stretching exercise also help in relieving the cramps.

 

 What When should a doctor be consulted for painful menstrual periods?

A doctor may be consulted if self-care measures have not relieved the pain for 3 consecutive months or if there is a history of passage of large blood clots. Also occurrence of pain more than 5 days prior to the period and continuation after the period gets over warrants a doctor‘s consultation. Any pain that incapacitates the female and interrupts her daily routine should be consulted.

 

 What What is pre-menstrual syndrome?

Premenstrual syndrome (PMS) involves symptoms that occur in relation to the menstrual cycle. The symptoms usually begin 5 to 11 days before the start of menstruation. Symptoms usually stop when menstruation begins, or shortly thereafter. These symptoms may include headache, swelling of the feet, backache, abdominal cramps, breast tenderness, bloating sensation, increased irritability etc.

 

 What What are the causes of PMS?

An exact cause of PMS has not been identified. It occurs more often in women between their late 20s and early 40s; those with at least one child; those with a family history of depression, or women with a past medical history of depression after delivery of first child.

 

 What How can premenstrual syndrome be managed at home?

It is easy to manage PMS at home. Self-care methods for managing PMS include:
(i) Regular Exercise – at least twenty minutes to half an hour every day, which may include brisk walking or cycling.
(ii) Dietary measures: Increased whole grains, vegetables, fruit, and decreased or no salt; sugar and coffee may prove beneficial.
(iii) Maintain a daily diary or log to record the type, severity, and duration of symptoms.A "symptom diary" should be kept for a minimum of 3 months. The diary will greatly assist the doctor not only in the accurate diagnosis of PMS, but also with the proposed treatment methods.
(iv) It is important to get adequate rest.

 

 What When is a heavy menstrual period said to be occuring?

If there is soakage through a sanitary pad every hour for 6 consecutive hours, this is considered a very heavy period.

 

 What What are the common causes of heavy menstrual periods?

The common causes of heavy menstrual periods include:
(i)Growths on the uterine lining.
(ii) Unexplained also called, dysfunctional uterine bleeding.
(iii) Thyroid gland problems.
(iv) Blood clotting disorders.
(iv)Sometimes, Intra Uterine Device
(v) Stress.

 

 What What is a prolonged menstrual period?

A prolonged period is one that lasts longer than 7 days.

 

 What What are the common causes of prolonged menstrual periods?

Prolonged menstrual periods may result from:
(i)Ovarian cysts.
(ii) Sometimes the cause may not be found-referred to as dysfunctional uterine bleeding.
(iii)Bleeding disorders and intake of medicines which impairs the normal clotting process of the blood (anti clotting drugs).
(iv) Stress.

 

 What What is an irregular menstrual period?

An irregular menstrual period is one in which the duration can vary excessively from cycle to cycle, with the periods occurring too frequently or being separated by an unusually long duratio

 

 What Is it normal to have irregular periods during the first few teenage years?

Yes, it is perfectly normal to have irregular periods during the initiation of menstruation in a girl‘s life. At first, the menstrual periods typically are irregular. The girl may have 2 months between periods, or may have two periods in 1 month. Over time, they become more regular.

 

 What What are the causes of irregular menses?

Menstrual periods that are frequently abnormal can be caused by:
(i) Endometriosis, it is a condition of unknown cause that can lead to pelvic pain and frequent bleeding.
(ii) Sometimes, the cause is unclear, in which case the woman is said to have dysfunctional uterine bleeding.
(iii)Ovarian cysts.
(iv) Stress.
(v) Cancers of the genital tract.

 

 What Is there a cause for worry if bleeding during menses lasts for only 2-4 days instead of the usual 5 days?

No, there is no need to worry. Periods change over time and from cycle to cycle.

 

 What What needs to be done in case of heavy, prolonged or irregular menstrual periods?

(i) Keep a record of your menstrual cycles, including when menstruation begins and ends, how much flow you have (count numbers of pads used, noting whether they are soaked), and any other symptoms you experience.
(ii) Consult a doctor if the problem persists beyond 3 months.

 

 What What is absent menstruation?

Absent menstruation refers to appearance of no menstruation by age 16.The causes may include:
(i) Birth defects of the female reproductive system.
(ii)Lack of an opening in the membrane at the entrance of the vagina (hymen).
(iii)Problem with glands producing hormones in the brain.

 

 

Abnormal vaginal discharge

 What What is vaginal discharge and when is it said to be abnormal?

Vaginal discharge is composed of mucous secretion produced by the cervix. Disease may be indicated if vaginal discharge is abnormal in color, odour, or consistency, or significantly increased in amount.

 

 What Which are the conditions that lead to an increase in the normal vaginal secretion?

The amount of normal vaginal discharge may be increased in conditions such as sexual excitement, emotional stress and ovulation (when you produce and release an egg from your ovary in the middle of your menstrual cycle).

 

 What What are the causes of abnormal vaginal discharge?

These conditions can lead to abnormal vaginal discharge:
(i) Sexually transmitted infections.
(ii)Fungal/yeast infection of the vagina common in diabetics and those with weak immune system.

 

 What What is a yeast infection (candidia)?

Small amounts of yeast fungus are often found in a healthy vagina. But excessive growth can cause a yeast infection.

 

 What Why does yeast infection occur?

Yeast infections usually aren't caught from a sex partner. A person may be more likely to get a yeast infection if he/she is using antibiotics, is pregnant, has diabetes, or stays hot and sweaty for long periods. Some women get frequent yeast infections for no obvious reason.

 

 What How does one knows that discharge is due to yeast / fungal infection?

Signs of yeast infections are intense itching, white cottage cheese like discharge, swelling and pain around the vulva and painful sexual intercourse.

 

 What How are yeast infections treated?

Yeast infections are usually treated with a medicine to be put / used in vagina. Yeast infections may also be treated with oral medicine. If a person yeast infections often, doctor may suggest use of a medicine one can buy without a prescription. But if there are doubts about what's causing this vaginitis, person should consult doctor. Many other things besides a yeast infection can cause vaginitis.

 

 What Should the sex partner also be treated?

Sometimes. Consult the treating doctor if sexually active. One may also need to avoid having sex or use condoms until treated.

 

 What WHow can abnormal vaginal discharge be prevented?

It is easy to prevent the abnormal vaginal discharge. To help prevent vaginal discharge:
(i)Genital area must be kept clean and dry.
(ii) Douching (splashing water into the genital area ) should be avoided. While many women feel cleaner if they douche after menstruation or intercourse, it may actually worsen vaginal discharge because it removes healthy bacteria lining the vagina that are there to protect them from infection.
(iii) Stress should be avoided.
(iv) Condoms must be used to avoid catching or spreading sexually transmitted diseases.
(v) Blood sugar should be kept under good control in case there is presence of diabetes.

 

 What What is a prolonged menstrual period?

A prolonged period is one that lasts longer than 7 days.

 

 What How can vaginal infections be prevented?

To prevent infection of the vagina, following things may be kept in mind:
After using the toilet, genital area should be washed from front to back. This may help to prevent bacteria from the rectal area to get into the vagina
Wearing cotton underpants during the day. Cotton allows the genital area to breathe. Underpants should not be worn at night.
Wearing tight paints, pantyhose, swimming suits, biking shorts or leotard for long period should be avoided. Laundry detergent or fabric softener should be changed if it is irritating the genital area
Hot rubs should be avoided
Daily Bathe or shower should be taken and the genital area pat dried Douching should not be done.

 

 What Should a doctor be consulted for an abnormal vaginal discharge?

An abnormal vaginal discharge is a sign of some underlying disease. A doctor should be consulted promptly. Your doctor will take a brief history about your symptoms, conduct a pelvic examination and prescribe a treatment accordingly.

 

 What Why is douching harmful?

The chemicals in douches may irritate the vagina and change the normal balance of germs in the vagina. Douching can also spread an infection into the uterus, increasing risk of getting pelvic inflammatory disease (PID). PID is an infection of the fallopian tubes that can cause infertility. Douching is not necessary to keep the body clean. Smells that one notices usually come from outside the vagina (vulva). Keeping this area clean with gentle soap and water can prevent smell.

 

 What What is the reason for “no relief” from white discharge even after treatment?

The treatment may be incomplete infection may have occurred again. After treatment preventive measures should be taken to prevent re-occurrence. A Gynaecologist/doctor should be consulted.

 

 What Does white discharge lead to shedding of bones?

No it does not lead to shedding of bones.

 

 

Ovarian cysts

 What What are ovarian cysts?

An ovarian cyst is a growth or swelling on, or inside, the ovary. It may be solid, or filled with fluid.

 

 What Are ovarian cysts cancerous?

The vast majority of ovarian growths are not cancerous

 

 What What are the symptoms of ovarian cysts?

Many women experience no symptoms when they have an ovarian cyst, particularly if it's small. Otherwise, they may present with these symptoms:
(i)Certain cysts grow large and may cause the abdomen to swell.
(ii) Depending on where the cyst is and its size, it may put pressure on the bladder or bowels, making the lady need to go to the toilet more often.
(iii)You may also notice abdominal discomfort and sex may be uncomfortable or painful.
(iv)Your periods may be affected; they may become irregular or the bleeding may be heavier or lighter than usual.
(v) Appearance of excess facial and body hair. (vi) Deepening of voice.

 

 What What is the treatment for ovarian cysts?

While some cysts may disappear on their own, other cysts may need surgery. Your doctor will discuss with you the pros and cons of surgery.

 

 

Polycyctic Ovarian Syndrome (PCOS)

 What What is Polycystic Ovary Syndrome (PCOS)?

Polycystic simply means 'many cysts' and describes the appearance of the ovary on ultrasound scan.

 

 What What are the symptoms of PCOS?

The symptoms of PCOS include: (i) Irregular or absent periods (ii) Infertility (iii) Unwanted body hair (iv) Acne (v) Weight gain (vi) Abdominal discomfort.

 

 What What is the treatment for PCOS?

PCOS can be treated by hormonal medicines or surgery. The discretion for treatment lies with the doctor.

 

 

Prolapse

 What What is prolapse?

Prolapse refers to descent ofa pelvic organ like uterus, bladder, urethra or rectum into the vagina.

 

 What What are the causes of prolapse?

Prolapse occurs as a result of weakening of the pelvic muscles due to:
(i)Repeated childbirth.
(ii)Old age.
(iii)Lumps in the uterus.
(iv)Obesity.
(v) Spinal injuries.

 

 What What are the common symptoms of prolapse?

Symptoms that may be occur with all types of prolapse:
(i) Feeling a lump or heavy sensation in the vagina.
(ii) Lower back pain that eases when you lie down.
(iii)lower abdominal pain or pressure.
(iv) Pain or lack of sensation during sex.
(v)inability to control urination and leaking urine.

 

 What What treatment options are available for prolapse?

Mild degrees of prolapse can be treated by,
(i) Pelvic exercises
(ii) Inserting vaginal pessary to hold the prolapsed organ in place.
Severe degrees of prolapse need to be corrected by different kinds of surgery.

 

Vulval pain and discomfort

 What What can cause vulval pain and itching?

Vulval itching is an irritating problem. Pain, itching, burning and irritation of the vulval area can be the result of a vaginal infection, or the result of a non-infectious skin problem such as dermatitis, eczema.

 

 What What are the causes of noninfectious skin diseases which can cause vulval pain and discomfort?

It is not always necessary that vulval discomfort is due to any infection. A woman's vulva can also be affected by skin allergy. Soap, disinfectants and detergents used for washing underwear can easily irritate vulval skin.

 

 What How can vulva skin problems be treated?

Treatment often includes using a steroid cream and emollients which are bland creams and ointments free of skin irritants. They can be used to soothe and hydrate sore and cracked skin and as a soap substitute to clean the vulva. They are available as creams and lotions and are available from chemists without a prescription. Steroid creams should not be used without consulting a medical doctor.

 

 What What is the commonest cause of swelling in the vulva?

The commonest cause for swelling in the vulva is known as ?Bartholin‘s cysts?. Bartholins glands are two tiny glands present on both sides of the vaginal opening. There are tiny ducts in the gland and if those get 'clogged' up by skin cells or secretions, it can form a cyst - (a fluid filled sac). The cyst can grow from the size of a pea to larger than a cricket ball.

 

 What How is Bartholin’s cyst treated?

The treatment really depends on several things; the size of the cyst, how painful it is, and whether it is infected. Some cysts are just treated with oral antibiotics. Sometimes your gynecologist might decide to put a 'drain' into the cyst. The drain (like a thick string) stays in place for about 2 to 4 weeks. This allows the fluid to drain and causes a small opening to form inside the lip of your vagina. The drain is removed after that 2 - 4 week period.

 

 What How can a woman care for her vulval skin?

It is important to take care of the skin of and around vulva if you are prone to vulval problems. Avoid synthetic underwear and try cotton underwears that are not too tight. Use mild soap for washing the vulval skin.

 

Obstetric fistula

 What What can cause vulval pain and itching?

A fistula is a passage/hole between a woman's birth passage and one or more of her internal organs. This passage/hole develops over many days of obstructed labor, when the pressure of the baby's head against the mother's pelvis cuts off blood supply to delicate tissues in the region. The dead tissue falls away and the woman is left with a passage between her vagina and her bladder and sometimes between her vagina and rectum. This passage results in permanent leaking of urine and/or feces.

 

 What What are the causes of obstetric fistula?

A fistula results from an obstructed labor that is left unrelieved and untreated.This usually happen if there is delay in seeking medical attention during labour; delay in reaching a medical facility; and delay in receiving medical care once arriving at a health care facility.

 

 What Can a fistula be cured?

Yes. An obstetric fistula can be closed with surgery. If her surgery is performed by a skilled surgeon, a fistula patient has a good chance of returning to a normal life with full control of her bodily functions. The operation has more than 90% chance of success.

 

Cancers and growths of the reproductive tract

 What What is cancer?

Cancer affects body's basic unit, the cell. Cancer occurs when cells become abnormal and divide without control. This mass of extra tissue, called a growth or tumor, can be benign or malignant.

 

 What What is a benign tumor?

Benign tumors are not cancerous. They can usually be removed and, in most cases, they do not come back. The most important thing is that cells from benign tumors do not spread to other parts of the body.

 

 What What is a malignant tumor?

Malignant tumors are cancer. Cancer cells can invade and damage tissues and organs near the tumor. Cancer cells also can break away from a tumor and enter the bloodstream and spread throughout the body.

 

Cervical cancer

 What What are the causes of cervical cancer?

Although exact cause is not known, HPV infection is implicated in most cases of cervical cancer. If HPV infection persists in a women‘s cervix over long period and her immunity is low it causes change in the cells of cervix which later get converted to cancer

 

 What Who are the women at risk of getting cervical cancer?

Not all women are susceptible to cervical cancer. Women who are at risk of getting cervical cancer are those who:
(i)Have multiple sexual partners.
(ii)Started sexual intercourse early in life –during teens or early twenties
(iii)Women with history of genital warts or chronic sexually transmitted infections

 

 What What are symptoms of cervical cancer?

In the initial stages, cervical cancer does not produce symptoms. Symptoms are produced when the cancer cells start invading nearby tissues. The most common symptom is abnormal bleeding. Bleeding may start and stop between regular menstrual periods, or it may occur after sexual intercourse. Menstrual bleeding may last longer and be heavier than usual. Increased vaginal discharge is another symptom of cervical cancer. These symptoms may be caused by cancer or by other health problems. Only a doctor can tell for sure. It is important for a

 

 What Do condoms prevent the spread of HPV?

Recent studies suggest that regular condom use provides some protection against the HPV infection. However, since condoms do not cover all areas that can be the source of the spread of HPV, they do not offer complete protection. Also, occasional use of condoms was not shown to offer any protection from HPV. To realize protection from HPV infection, you must be committed to using condoms every time you have sex until you are in a committed relationship.

 

 What What are symptoms of cervical cancer?

In the initial stages, cervical cancer does not produce symptoms. Symptoms are produced when the cancer cells start invading nearby tissues. The most common symptom is abnormal bleeding. Bleeding may start and stop between regular menstrual periods, or it may occur after sexual intercourse. Menstrual bleeding may last longer and be heavier than usual. Increased vaginal discharge is another symptom of cervical cancer. These symptoms may be caused by cancer or by other health problems. Only a doctor can tell for sure. It is important for a

 

 What Can cervical cancer be prevented?

Yes, cervical cancer can be prevented by early detection of changes in the cervix by means of getting a regular cervical smear or Pap smear test done.

 

 What Can cervical cancer be treated?

Yes, cervical cancer can be treated when detected early .These changes in the cervix can be detected by means of getting a regular cervical smear or Pap smear test done.

 

 What What is a cervical smear or Pap smear test?

A smear test is a simple examination to check the health of a woman‘s cervix. It is called a smear test (or Pap smear) because the doctor or nurse takes a small sample of cervical cells and smears them onto a glass slide to be analyzed under a microscope

 

 What Who should have a smear test?

All sexually active women should get a cervical smear test done every 3 to 5 years.

 

 What Is there any need for a non-sexually active woman to get her smear test done?

Cervical cancer is extremely rare in women who have never been sexually active; therefore most recommendations suggest women don‘t need to have smears until they‘ve had sex.

 

 What How is a Pap smear done?

A warmed speculum is passed into the vagina to separate the walls so the doctor can see the cervix. A wooden spatula (thinner than a tongue depressor) is wiped across the cervix, and the smear is transferred to a glass slide.

 

 What When is the best time to get a smear done?

The best time to get a smear done is between the middle of your menstrual cycle – about half way between one period and the next. It‘s easiest to get a good cell sample from your cervix at this time.

 

 What What are the precautions to be taken before getting the Pap smear?

The woman should refrain from having sex, douching or using feminine creams, lotions or hygiene products for 24 hours before taking the test. The test should be done when she is not menstruating, preferably between the middle of the menstrual cycle(day 14-17).

 

 What What are the different kinds of Pap smear results?

Results of a pap smear may range from normal to inflammatory to precancerous/cancerous. These are diagnosis made by the pathologist and interpretation of the smear result is made by treating clinician/ doctor

 

 What What should one do if pap smear is not normal?

A Gynaecologist/doctor should be consulted for diagnosis and treatment.

 

 What Is the Pap smear always accurate?

No. As with any lab test, there is a possibility for error. If it is felt by the examined lady or the doctor that the results are not accurate, a repeat Pap smear or colposopy can be done to get a better look at the cervix and increase the likelihood of correct diagnosis. By colcoscopy a direct view of the cervix in magnified view is obtained

 

 What Is any vaccine available for protection against cervical cancer?

Yes, a vaccine (HPV Vaccine) is now available which protects against a virus known as Human Papilloma virus which is responsible for causing 70 % of cervical cancers.

 

 What Who should receive the HPV vaccine?

The vaccine is for girls and women ages 9 to 26 years. It works when given before the initiation of sexual activity and one has any contact with virus.

 

 What How is HPV Vaccine administered?

The vaccine is administered as 3 injections given over a span of 3 months.

 

 What What are its side effects?

It can cause pain, swelling, itching, and redness at the injection site. Fever, nausea, and dizziness occur sometimes after the injection. These are minor side effects and can happen after any injection.

 

 What Does the vaccine protect everyone who is vaccinated against cervical cancer?

The vaccine may not fully protect everyone and does not prevent all types of cervical cancer, so it is important to continue regular cervical cancer screenings.

 

 What How effective is vaccine against cervical cancer?

Studies have shown 100% effectiveness in protecting against infection with HPV-16 and HPV-18 strains in people who had not been previously exposed to the virus.

 

 What How long does the effect of vaccine against cervical cancer last?

Tests show that the effect of vaccine lasts at least four years. Long-term results aren't known yet.

 

 What Is cervical vaccine safe?

Reports from clinical trials, to date, show vaccines against cervical cancer are safe.

 

 What Will vaccine protect women from cervical cancer who've already been exposed to HPV?

Cervical vaccines are not designed to protect people who've already been exposed to HPV.

 

 What Will the new vaccine against cervical cancer eliminate the need for cervical cancer screening?

No. Cervical vaccine doesn't protect against all causes of cervical cancer, so screening (such as the Pap test) will still be needed. Screening is essential to detect cancer and precancerous lesions caused by other HPV types. Screening will also continue to be necessary for women who have not been vaccinated or are already infected with HPV.

 

Ovarian cancer

 What Who are the women who are at risk of getting ovarian cancer?

The exact cause of ovarian cancer is not known. However, studies show that the following factors may increase the chance of developing this disease:
(i) Family history. First-degree relatives (mother, daughter, sister) of a woman who has had ovarian cancer are at increased risk of developing this type of cancer themselves
(ii) Age. The likelihood of developing ovarian cancer increases as a woman gets older. Most ovarian cancers occur in women over the age of 50, with the highest risk in women over 60.
(iii) Women who have never had children are more likely to develop ovarian cancer

 

 What What are the symptoms of ovarian cancer?

The symptoms of ovarian cancer are almost similar to those of other ovarian conditions such as menstrual disturbances and abdominal discomfort. At times, the symptoms may be vague such as loose motions, weight loss etc. Thus, you should see your doctor promptly

 

 What What are the treatment options for ovarian cancer?

Treatment options and outcomes for patients who have ovarian cancer depend on the exact classification of the cancer and how far it has spread before it is diagnosed

 

 What Is there any screening test for preventing ovarian cancer?

No screening test has yet been developed for early diagnosis of ovarian cancer.

 

Urinary incontinence

 What What are the causes of urinary incontinence?

Urinary incontinence is usually caused by problems with muscles and nerves that help to hold or pass urine. Urine is stored in the bladder. It leaves the body through a tube that is connected to the bladder called the urethra. Muscles in the wall of the bladder contract to force urine out through the urethra. At the same time, sphincter muscles around the urethra relax to let the urine pass out of the body. Incontinence happens if the bladder muscles suddenly contract or the sphincter muscles are not strong enough to hold back urine. It is twice as common in women as in men. Pregnancy, childbirth (particularly home births), and menopause are major reasons. Other reasons are brain injury, birth defects, stroke, diabetes, multiple sclerosis, and physical changes associated with aging

 

 What What are the types of urinary incontinence?

Urinary incontinence can be of three types:
Overflow incontinence: One can have overflow incontinence whereby the bladder fills, doesn't empty, and reaches its capacity and then the patient leaks urine more or less on a continuous basis.
Stress incontinence: Another type of incontinence is stress incontinence. This is usually associated with activity, lifting, coughing, running.
Urge incontinence: It is caused by a bladder contraction that occurs when the patient is not trying to empty their bladder. Typically, patients will complain that they feel the need to empty their bladder but begin leaking before they can reach a bathroom.

 

 What Is incontinence a problem seen mostly in the elderly?

Incontinence is certainly more common age of the woman increases, but incontinence can be seen in children, adolescence and adults, both male and female.

 

 What Is incontinence a problem seen in diabetes?

Incontinence can certainly been seen in the diabetic patient. Diabetics tend to have decreased bladder emptying and are somewhat prone to having overflow incontinence, but may also have stress or urge incontinence and therefore need a complete evaluation prior to treatment.

 

 What Can incontinence come and go? Some weeks I have no problems.

Yes, incontinence can come and go depending on its cause. For instance, some patients will complain of stress incontinence only when they have a severe cold with coughing or during periods of excessive activity. Patients with urge incontinence frequently report increased leakage during cold weather and sometimes related to dietary factors such as excessive fluid intake, particularly with products containing caffeine such as coffee

 

 What When I cough urine passes automatically even though I did not feel like I had to go to the bathroom. I don't have any type of abdominal pain. Should I be concerned about this?

Losing urine with cough or abdominal straining is called stress urinary incontinence. If it happens enough to wear a pad for when you have a bad cold, probably not much treatment is needed. If it persists after your current illness, you may want to tell your gynaecologist about it and see if the changes are mild or severe.

 

 What What kinds of tests are needed to diagnose stress urinary incontinence?

The only test needed to diagnose stress urinary incontinence is to cough and see urine leak from the urethra, your doctor usually does this during a pelvic exam. If urine does not leak while checking you when laying flat on a table, the doctor may ask you to stand up and put one leg on a stool and then have you cough while checking for leakage. You can check yourself by holding a paper towel or thin cloth (handkerchief) over the vagina and urethra with one leg up on a stool or chair. Then a strong cough and see how wet the paper towel is. If the paper towel is not wet at all, then you may have a different type of urinary incontinence. Other urodynamic studies are often used to rule out other types of incontinence and urinary problems but not to diagnose stress incontinence.

 

 What What are the treatment options for urinary stress incontinence?

There are several different non-surgical treatments for stress incontinence and they are most successful if you are near your menopause and the urine loss only happens with severe coughing or straining. Surgery may also be needed in some cases.

 

 What What are the treatment options for urinary stress incontinence?

There are several different non-surgical treatments for stress incontinence and they are most successful if you are near your menopause and the urine loss only happens with severe coughing or straining. Surgery may also be needed in some cases.

 

 What I am 45 years old and have developed incontinence at night while in bed. Often, I will urinate while dreaming and wake up in wet clothes. Other times, I will be in bed and have a severe urge to urinate but cannot get out of bed in time to make it to the bathroom. I don't seem to have the problem when I'm awake and up and about. However, sometimes, I'll be driving home and all of a sudden has an urge to urinate. Why is this happening to me?

What you describe sounds like urge incontinence with a hyperactive bladder or possibly overflow incontinence. You require tests to diagnose this. The common tests are catheterization for the amount of urine left in your bladder after voiding and a cystometrogram (involves a catheter and filling of the bladder). These tests are available with the hospitals, both government and private. The mainstays of treatment are bladder retraining and medical therapy.

 

 What How can I do bladder retraining for urge incontinence?

Bladder retraining can be done at home. It involves keeping the bladder empty before you get the urge to void. To do this, void every hour during daytime for a week. You void whether or not you have the urge to void. You need a timer to do this or a watch that you can set to "beep" every 60 minutes. If you get an urge at 55 minutes to void, try to suppress if you can until time is up. The next week you go to 1.5 hours (90 min), the following weeks to 2.0 hr, then 2.5 hr, then 3 hours. Don't go longer than 3 hours in the daytime without voiding. It takes 5 weeks or sometimes longer of this bladder retraining to get better.

 

 What What are Kegel exercises and whom do they benefit?

Kegel exercises are also known as pelvic floor muscle strengthening exercises and are designed to strengthen the muscles that support the pelvic floor and maintain continence. Kegel exercises will benefit patients with stress or urge incontinence and are very worthwhile treatments as they have virtually no side effects and a relatively high degree of success. Steps to do Kegel‘s exercise:
First, try practicing these exercises while lying down.
Squeeze/contract the muscles in your genital area as if you were trying to stop the flow of urine or trying to stop from passing gas. Try not to squeeze the muscles in your belly or legs at the same time. Try to squeeze/contract only the pelvic muscles. Be extra careful not to tighten your stomach, legs, or buttocks.
Relax. Squeeze/contract the muscles again and hold for 3 seconds. Then relax for 3 seconds. Work up to 3 sets of 10 repeats.
When your muscles get stronger, try doing your exercises while sitting or standing. You can do these exercises any time, while sitting at your desk, in the car, waiting in line, doing the dishes, etc.

 

 What I am a 43-year-old female; 3 full term pregnancies. I have urinary leakage. I wear a pad everyday. Do I need surgery, or is there something else available?

Urinary incontinence is common in women.All types of urinary incontinence are treatable.The first thing that you should have is an evaluation by a doctor to see what type of incontinence you have. Generally speaking, incontinence falls into several categories. The treatments for these different types of incontinence generally fall into two categories: Conservative management with medications, exercises and yoga (deep breathing) devices such as a pessary and sometimes biofeedback, and more invasive forms of therapy such as surgery. The type of incontinence, which is diagnosed during the evaluation, will dictate which type of treatment is appropriate.

 

Low back ache/PID

 What What are the gynaecological causes of low back ache?

A woman can have low back ache which are not bony, muscular or nerve in origin. The causes may be as follows:
Uterine prolapse with retroversion which may drag on the pelvic ligaments causing backache; this gets relieved on lying.
Tubo- ovarian mass, parametritis and chronic cervicitis: these are diseases of cervix, uterus or ovaries also known as pelvic inflammatory diseases or PID.
Benign and malignant pelvic tumours-impacted uterine fibroid or ovarian cyst, pelvic endometriosis, advanced cancer of cervix, retroperitoneal tumour.
Postoperative because of sacro-iliac strain following gynaecological operation in lithotomy position under anaesthesia.
Premenstrual low pain especially in premenstrual syndrome.

 

 What What is PID?

Pelvic Inflammatory Disease or PID is an infection of the female reproductive organs (the fallopian tubes, uterus, and ovaries). It is usually caused by a sexually transmitted organism.

 

 What Who gets PID?

Any woman can get PID, but women who have multiple sexual partners, practice unsafe sex, maintain poor hygiene or gets treated by quacks who perform internal examination is most likely to get a STD, which can lead to PID.

 

 What How does someone get PID?

PID usually begins with an infection of the cervix (the opening to the uterus) with organisms transmitted through unprotected sex, such as gonorrhea or chlamydia. If the infection of the cervix is not treated with antibiotics, it can spread to the endometrium (lining of the uterus), and then to the fallopian tubes, uterus, ovaries, and

 

 What Can incontinence come and go? Some weeks I have no problems.

Yes, incontinence can come and go depending on its cause. For instance, some patients will complain of stress incontinence only when they have a severe cold with coughing or during periods of excessive activity. Patients with urge incontinence frequently report increased leakage during cold weather and sometimes related to dietary factors such as excessive fluid intake, particularly with products containing caffeine such as coffee abdomen. PID rarely occurs after having certain surgical procedures, such as an abortion, or after treatment for an abnormal Pap test.

 

 What When I cough urine passes automatically even though I did not feel like I had to go to the bathroom. I don't have any type of abdominal pain. Should I be concerned about this?

Losing urine with cough or abdominal straining is called stress urinary incontinence. If it happens enough to wear a pad for when you have a bad cold, probably not much treatment is needed. If it persists after your current illness, you may want to tell your gynaecologist about it and see if the changes are mild or severe.

 

 What What are the symptoms of PID?

A woman with PID may not always have symptoms. However, the symptoms of PID can include:
Lower abdominal pain and/or lower back pain
Longer and/or heavier menstrual periods
Cramps or spotting throughout the month
Unusual vaginal discharge (change in smell, color, or amount)
Tiredness, weakness
fever Vomiting, nausea
Pain during sex
Pain or burning when urinating
If you notice any symptoms of PID, you should see your health care provider/doctor right away. The infection can spread higher and cause worse pain and damage to your reproductive organs in just a day or two.

 

 What How is PID diagnosed?

Your health care provider can tell if you likely have PID based on your symptoms, a pelvic exam, and blood tests. You may have pain when your doctor does internal examination and move your cervix or examines your ovaries or uterus. Sometimes an ultrasound is used to look inside at your reproductive organs to see if there is any sign of an abscess or other condition. Occasionally a laparoscopy (a minor surgery to look at your reproductive organs) will be needed to correctly diagnose PID if you are not getting better.

 

 What How is PID treated?

Depending on how sick you are, you may be treated either in a hospital or as an outpatient. You may receive antibiotic for 2 weeks. It is very important to take all of the pills, or you could get sicker. A few days after you start taking medicine, you will need to see your health care provider again. If you don't get better, you may need to have more tests and/or take different medications. If you find out you have PID, you need to make sure your husband/partner gets treated. Unless your partner is treated at the same time as you, you may get infected again.

 

 What Is PID dangerous?

PID can be dangerous if not treated early. Scar tissue can form in the fallopian tubes and inside the abdomen. These scars can block the fallopian tubes, which can cause difficulty in getting pregnant or infertility. If the tubes are partly blocked, fertilized eggs may not reach the uterus and the pregnancy can form in the fallopian tubes (known as a tubal or ectopic pregnancy, which is dangerous). Scarring can cause pain that lasts for months or even years. If the effects of PID are very severe, sometimes surgery may be needed to treat scar tissue. PID is more likely to come back if you get an STD again. Also, the more times you have PID, the more likely you are to have problems and more harm to your body.

 

 What How can PID be prevented?

To prevent PID, you need to avoid getting an STD. The best ways to do this are:
If possible, avoid premarital and extra marital sex.
If you do have sex, use a latex condom correctly every time.
Limit the number of sexual partners you have.
Don't use douches. Douches can spread the bacteria further up the vagina.
Don't smoke cigarettes.
Finish all your antibiotics if you are being treated for a cervical infection or PID. Make sure your partner get treated for STD's.

 

 What Is it true that calcium is necessary for low back ache?

Low back ache in a woman has many causes. If it is due to any gynaecological causes, calcium will not help. Thus before starting calcium supplement always consult your health care professional.

 

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