Agarwal Medical Centre

Hello,

I am Dr. Krishna Agarwal, Gynaecologist. Today I am going to speak about a common problem i.e. menorrhagia. It means excessive blood flow during menstruation. Normally, blood should flow 4-5 days and every 30 days. For the first 2 days, it should be heavy but for rest days it should not be heavy. Or if it is happening expected than the longer period or heavy then it is called menorrhagia. It can be of 2 types where the cycle is of 30 days but the length of bleeding is more. And the 2nd type is where the cycle is shortened i.e. you are bleeding in less than 25 days, it can be 20 days, 15 days. If you have this kind of bleeding, this also comes under menorrhagia. Now it is a problem which has a lot of bad effects on the person's health. The cause of this problem is ovulation because when they start menstruation, it is not perfect. Their eggs are not perfect, they are not properly coordinated. Hormones are not adequate either from pituitary or the responsive ovary.

The girl has only estrogen and the ovulation doesn't occur and progesterone is not there. This kind of cycles has excessive bleeding. But this should not last for more than 2-3 years at the time of pituitary. Next cause is calcium and vitamin C deficiency. Most of the calcium we are getting from milk. Earlier days everybody used to drink a lot of milk. But nowadays it is not in fashion and people don't like it. And also the quality of milk is not good. People are not getting the exposure of sunlight causing vitamin D deficiency. Because of the calcium does not get dissolved. Vitamin C is also important for the integrity of small capillaries. It causes repeated ruptures and resulting in menorrhagia during menses. Then fibroid and polyp of the uterus also cause menorrhagia.

So, both should be excluded by ultrasound or hysteroscopy. The infection is another cause of menorrhagia because it causes widespread inflammation so the blood flow to the pelvis is increased. Because of inflammation vessels are also not so healthy. Both resulting in heavy menstruation. Nowadays abortion pills have come up, incomplete abortion has become another cause of menorrhagia. Because small amount left of the reproductive product keep causing bleeding. A left copper-T or a forgotten copper-T in the uterus also causes excessive bleeding. This problem should not be taken lightly because it is causing the loss of blood. Loss of blood makes a lot of difference to the body. Losing blood means losing protein, iron and losing all other components like calcium, magnesium, phosphorus, and vitamins. It should be treated on time so that the body health should not deteriorate.

This will also cause infertility because due to heavy bleeding it doesn't get implanted properly inside the uterus. Now heavy menstruation will also cause endometriosis. Because of so much blood when uterus contracts, some of the blood gets into the tube, it goes into the pelvis and causes ectopic endometrium. Because of this many other complications occur. So, heavy menstruation should be checked in time. Heavy menstruation causes dysmenorrhea i.e. excessive pain during menstruation because the uterus has to work harder to extrude the blood. Prolong bleeding may also result in infection because of this act as a foreign body. Therefore, menorrhagia should not be taken lightly. It should be taken care of in time so that the girl remains healthy all her life.

Thank You.

Hello,

I am doctor Krishna Agarwal. I am a gynecologist. I have got about 40 years of experience ever since I passed my MBBS.

Today I am going to speak about infertility. Infertility could be due to a male factor or female factor or combine. Males are responsible for almost 30% of cases of infertility, while females are another 30% and combined factors are 40%. The male factors are as important as female factors and it should not be neglected in any case. The most common being, the sperms being less in the count or the morphology being bad along with that there are female factors and nowadays we are putting a lot of emphasis on female factors only. The most important of the female factor is an infection which is overlooked most of the time the infection causes endometriosis as well as tubal blockage. In earlier days when it starts immediately after marriage or so it can be treated easily and if treated in time, it is completely curable but if it is left for a long time then it results in different things like adhesions as well as tubal blockage.

The next common causes are deficiencies. Again something which is neglected because people think that this cannot occur or especially in a good class people but due to fads and fancies of different people, this is also a very common cause and here the factors could be deficiencies in iron, B complex, B12 and calcium. Calcium is a very important because early day people drank milk regularly, a good amount of milk but nowadays, because of fat but also because of the bad quality of milk coming, people are not drinking milk; moreover, people are living in inside AC rooms and not exposed to sun, causing vitamin D deficiency which ultimately leads to calcium deficiency and this calcium deficiency is a very important cause of infertility or missed abortions or bad defective foetuses.

Now B complex and B12, folic acid, these three deficiencies are very important because if there is lack of them, the division of the cell is not proper and the foetus which comes is either so defective that it doesn't grow or a defective baby is produced. The cause of congenital anomalies especially the physical anomalies in the babies, this is the most common cause.

Now the other causes of infertility could be stress. Stress is nowadays, especially it is very common that women are also working, they are looking after the house as well as an office because of stress they produce a lot of steroid hormones and the female hormone, estrogen is not produced adequately, causing an imbalance in hormone status and resulting in infertility.

Next common cause obesity, obesity we all know is bad for fertility because the estrogen gets stored in the fat cells of the body and is not available in the blood circulation and for the growth of uterine endometrium as well as the growth of the fetus, So obesity is also a very important cause of infertility.

The next common cause which should not be taken lightly is the blocked tubes, blocked tubes the commonest cause is the simple infection which occurs either because of some induced abortion or due to gonorrhoea. If it is left untreated for a long time which results into blocked tubes but if it is taken care of initially these blocked tubes can remain open and is treatable but after a certain time when the tubes are completely adherent or they are turned into hydrosalpinx then these blocked tubes are not treatable. At that stage, IVF is the only treating measure.

Tuberculosis, tuberculosis is very rampant in our country and the bacteria are there in the atmosphere for everyone and everyone contracts this during childhood. There are gems inside our body but our immunological system overcomes it and we remain healthy but whosoever immunologically they become we that is because of the deficient diet due to repeated illnesses of different kinds, such people the same germ which is present they flair up and they cause tuberculosis, it starts from lungs but then it can go through blood it gets nidated anywhere in the body and endometrium and tubes are also one of the common sites, where tuberculosis can occur and it results in infertility because it causes blocked tubes, it causes adhesions in the uterus and also the whole of the pelvic system, the pickup system gets deranged.

Other not so common causes are like fibroid in the uterus or a polyp inside the endometrium and the last one which should be considered is endometriosis because that's not the first call but it should be kept in mind but after we have excluded all other causes.

Now about male infertility, infection is the most common cause, which causes orchitis or epididymitis or prostatitis and all these will cause a bad milieu in the semen which causes the death of the sperm. So the sperms which are produced probably are healthy but because of the infection and different inflammatory substances in the semen, they are dead when they come out. The other thing which can happen when the infection is for a long time is there counts comes down and then the morphology also suffers and the person becomes either azoospermic or oligospermia and asthenozoospermia.

The other cause for the males is if somebody had developed orchitis initially at the time of puberty or later or trauma to the testis sometime in the life or even mumps, mumps is occurring at any age causes orchitis and in which the testicular tissue is destroyed and resulting into infertility.

The another important causes same as women like deficient status especially vitamin D, vitamin B12 and folic acid because again they hamper the cell division because it is the cell division, which is the basic cause of all the sperm and ovum formation and sperms are not from properly and this is one of the major causes especially these days because there is so much pollution in the air and there were so many pesticides in our food, even the fruits which are said to be the best vitamin giving objects. They are not so good because of the heavy amount of pesticides over them. Moreover, people are eating frozen food again which are devoid of any vitamins and they are ready to eat food, they are eating carbohydrate diet the takeaway foods, all this is causing a lot of dietary problems and which should be looked after.

Other causes, of course, can be a chromosomal defect, which is not such a common thing, though it can occur, then smoking and alcohol and another important cause which should be taken care of because both of them decrease the nutrients power of the blood and body and it is not so good.

Thank you.