Dr. Mohans ReDefine Health

Constant problems in women during intimate activity is enough to send you or your partner in agony. It is important to understand that it can be due to female sexual dysfunction. Female sexual dysfunction can happen at any stage of a woman's life and can be lifelong. Also it can be due to some situations or all sexual situations.

Namaskar,

I am Dr. Padmaja, Senior Gynecologist, Noida. Aaj hum log baat karenge ek bohot common se topic ke baare me: low back ache. Jisko ki hum log chronic lumbar pain ya lumbago bhi bolte hain.

Low back ache kya hota hai, hamari kamar ka neeche ka hissa, jo hamaare shareer ke upar ke hisse aur neeche ke hisse ko connect karta hai usko hum log lumbar region bolte hain. Iss region me hone wale kisi bhi pain ko hum log lumbago bolte hain. Now, lumbar region is very very important. Why this is very important ? Because ye kai saare functions perform karta hai. Ye structural link form karta hai hamare body ke upar aur neeche ke hisse me. Ye hamaare body ke bahut saare organs ko protect karta hai saath hi isi ke upar hamare body ke movements hote hai, jaise ki hum forward bending wagairah karte hain. Is hisse me jo pain hote hain, multiple kaarano se ho sakte hain.

Ye vertebral column ki wajah se ho sakte hain, pain spinal origin me ho sakte hain, disc ki problems me ki wajah se ho sakte hain. Is area me jitne muscles aur ligaments ho sakte hain uski wajah se ho sakte hain ya ye pain is area me body ke internal organs ko jo protect karte hain indirect diffraction unka bhi hota hai. Now, lumbar pain can affect both male and female, but today we will be talking about lumbar pain especially in relation to females. Female me hone wale lumbar pain ke samasyaon ke baare me baat karte hain. Pehle ye samjha jata tha ki lumber pains, ya chronic low back ache 40-45+ menopause ke aas paas wali ladies ko pareshan karte hain but actually it is not so. Aaj ke time pe with the kind of lifestyle we are leading, no age group is left unaffected. Because hum log offices mein baithe bohot der tak kaam karte hain. Our exercises and different kind of strains lead to different kind of problems in females.

Gyne opd me hamein 2 tarah ke patients aate hain. Aksar patient directly hamare paas aata hai, ki bohot dino se kamar me dard hai ya interdisciplinary approach ki tahat hamein different departments se especially orthopedic department se bahut saare patients aate hain to rule out gynaecological problem ki internal check-up kar lijiye koi Gynecological problem to nahi hai. If the clearances given, fir unka orthopedic ya medical point of view se evaluation hota hai. Now pain of gynaecological origin: Normally jo striyon me hone wali samasyaon se related pain hota hai it is usually diffused and dull ache. Dheema aur Constant pain hota hai which is chronically present all time. Koi bhi pain jisko aap finger se pin point kar sakte hain normally gynecological origin ki wajah se nahi hota hai. Kuchh age groups ya causes jinme problems aksar dekhe gye hain unke nimn prakar hain: young girls me menstruation ke time pe because uterus, ovaries aur Parietal peritoneum ki nerve supply aise hoti hai jab menstruation ke dauraan uterus me cramps hote hain to usually wo back pe bhi refered hote hain aur is tarah ke pain long lasting nahi hote hain aur ye menstruation ke saath saath khatam ho jaate hain. Second most common group which is affected by this back ache is in the child bearing age group especially during pregnancy. Now pregnancy me kya hota hai aapka because you are carrying a baby, apka posture jo hai lumbar curvature badh jata hai there is lumbar lordosis. So there is constant strain jo kamar ke muscles hain unpe constant khichav rehta hai.

Is kaaran se aksar lumbar pain rehta hai. Then after child bearing, kuchh log hote hain jinko deficiencies ki wajah se ya muscles spasm even after delivery persist karta hai and chronic back ache me badal jata hai to child before child delivery and even after the child delivery people can have pain. Second important to this is post operative. Kuchh logo ko operations ke baad kamar me dard rehne lagta hai. Kuchh log aise bhi hote hain jinme operation ke dauraan spinal anaesthesia wagairah dene se back ache lage rehta hai. Ek bahut important group jisme ki chronic back ache dekha gya hai. That is because of age related problems especially around the age of menopause. 45, 50, 55 years ki jo age group hai unme aksar ye pain dekha gya hai. Ye pain jyadatar hamare bodies me estrogen ki deficiency ke kaaran hone wale changes ki wajah se hota hai. In changes ki wajah se hamare muscles jo hain wo loose ho jaate hain, hamare bone mineral density kam ho jaati hai. To at this age backache is multifactorial. Other than this, people who are very active jo bahut exercise karte hain, yoga karte hain, bad postures me baithe rehte hain, unsupervised exercise karte hain especially in gyms and all, people are very active these days. Un cases me bhi bahut sara muscles spasm ya strain ki wajah se backache ho sakta hai. Another very important cause of backache in female is chronic genital infections. Females jinme ki internal organs me swelling rehti hain, infections rehti hain unme bhi chronic backache dekha gya hai.

In common causes ke alawa kabhi kabhi age related jab body me laxity ho jaati hain, aapke muscles power loose karne lagte hain, tone loose karne lagte hain jinme private parts me prolapse hone lagta hai, uterus thoda khisak kei neeche aa jata hai, peshaab ki thaili neeche khisak jaati hai , Cystocele wagairah hoti hai ye ya bahut cases me mass koi andar rasauli wagairah hai, un cases me bhi constant pressure ki wajah se aapko backache rah sakta hai. Now, these are very very common causes of chronic low backache. Ek sabse badaa important cause aaj ke time pe irrespective of sex and age is nutritional deficiencies. Because of our lifestyle, hum log raat me kaam karte hain din me sote hain, ghar se ac me gaadi me, gaadi se office me, office se ac me, fir gaadi me, fir wapis ghar me. So there is a lack of exposure to the sun and sun is an important factor for generating vitamin D in our skins and vitamin D is very very important for the density of bones. Vitamin D ko hum log vitamin D zaroor bolte hain but actually its not a vitamin it is a pro hormone which gets converted into our skin and is very very important hamari body me calcium metabolism ke liye, hamari body me homeostasis ke liye, nerves signals ke liye and man a times ye deficiency itni subtle hoti hai ki hum log usko overlook kar jaate hain. Saari cheezon ki investigations karte hain baar baar doctor ke jaane ke paas bhi humein koi diagnosis nahi milti hai.

Aksar in cheezon ka diagnosis banana thoda mushkil hota hai but agar aap aware hain aap time se test karaye, to you will find in indian population rather all over the world, Vitamin D is gradually developing as an epidemic. So nutritional causes also one of very important cause of backaches or rather ache throughout the body. Now how to deal with it. Do not overlook any pain. Koi bhi pain jo aapko kuchh hafton se jyada pareshan kar rha hai usko overlook mat kariye. Go and visit your doctor. Doctor ke yahan jaane se pehle kuchh chhoti moti remedies aap ghar pe bhi kar sakte hain jaise ki, fermentations hain, postural check karna, try to sit in the right posture. Try not to bend forward. Doctor ke paas jaane ke baad, jo bhi aapka test hota hai treatment me jo kaaran nikalta hai, uske hisaab se aapka treatment kiya jaayega. Par kuchh basic norms har cheez ke hamesha baraabar rehte hain, chaahe wo orthopedic ho, chaahe gynaecological problem ho. Agar wo menstruation ke dauraan hai to aapko simple chhota painkiller medicine se, right exercise, right posture, good eating habits. Aur agar infection ki wajah se hai to infection ka treatment hona chahiye. Agar aapko chronic problem hai, endometriosis wagairah ki to unka medical ya surgical management ho sakta hai.

In sab cheezon ke saath saath investigations ek bahut badaa important role play karte hain jinme ki aapka age related investigations hote hain. If you are young, you may not require so many investigations. If you are towards the menopause, you may require little more investigation. Jaise ki aapka blood counts kya hai, aapka sugar level kya hai, aapka glyc se related haemoglobin kitna hai, aapki bone mineral density kitni hai. So these will all help in determining the cause and the treatment of the disease. So, carry home message for you is, kisi bhi backache ko lightly na le, postural collections ka dhyaan rakhein, take good nutrition, visit your doctor and do take medicine on time. Physiotherapy has a very very important role to play, do your exercises and last but not the least, human body is not made for sitting. So if you are in an office, sitting for a very very long time, try to take regular breaks at desired intervals which may be a doctor can tell you.

So have a good day ahead! That's all from me.

Hi,

I am Dr. Padmaja Mohan, Gynaecologist. Planning of pregnancy in the late 20s and early 30s. If we look back about a couple of decades, the average age of getting married was 24-26 years. Now with the women empowerment, most of the females are going out and working. The age of marriage has gone up. These days women are getting married around the age of 28-35. The planning of pregnancy has also delayed. Now with something good or bad, there are certain disadvantages of getting married a little late. Now we would be discussing, what are the disadvantages. And what e can do to rectify these problems and timely plan a pregnancy. A number of eggs in a female body are decided when a female is born. And once you start menstruating, every month you keep on losing one egg. So, by the time you reach at the age of 28-30, your ovarian reserves are decreased. By mean of this, your number of eggs are narrowed down at a very lesser number. So, in case you want to get pregnant at that period of time, you really have to think and plan the pregnancy to have a successful pregnancy. Now, what can be your questions once you get married? When should I plan my pregnancy, how should I proceed forward, what should I do to get pregnant, what will be the ideal time? Because everyone is working these days. There is a lot of stress of job and performance also, social taboo also, in case you are not conceiving. Stress has also so many deteriorating factors on your body. We will be discussing these issues one by one.

Once you are getting married little late and you are planning a pregnancy, there are certain things you need to know as a part of pre-conceptional counseling. You need to know your blood group. What is your RH type? In case, you are RH negative, you must have heard blood group A+, B+, O-, AB-, so, in case your blood group is negative, it is mandatory that you also get your husband's blood group tested. In case, both of you are negative, it is fine, nothing really too worried about. But in case, you are negative and your husband is positive, you might require certain specialized investigation and certain vaccination to prevent RH immunization complications in pregnancy. So, that was about your blood group. Then you need to discuss vaginitis with the Dr. In case, there is a family history running, you need to discuss with the Dr prior to conception. Because there are certain investigations that are done to rule out certain genetic abnormalities which are likely to run in families. A very simple blood test is thalassemia. This screening is widely available and it is a part of antenatal and as well as preconceptions premarital screening as well. You need to discuss your nutritional status, health issues. There are people who are overweight. Overweight and obesity can cause diseases very commonly PCOS. Diet-related issues also have to be discussed. There are certain screening and vaccinations are required. Of course in India, there is no mandatory protocol but in abroad, there are strict norms. In India, we also have started following WHO norms. Certain screenings are very important like rubella, hepatitis, tetanus, seasonal flu vaccines are also available. Now, this was in relation to your medical history.

Certain things which also needs to be discussed are STDs. If you and your partner is suffering any kind of STDs, it should be treated prior to your conception. Next is certain lifestyle issues. If you are on alcohol, addicted to smoking, so no to all these kind of bad addictions. If you are on any kind of medications like epilepsy, there are people who might be taking medications, so they need to discuss this thing with their Dr. As a part of pre-conceptional counseling, we start giving folic acid supplements to the patient. This is given to both husband and wife to have a good quality of eggs and sperm. It gives you a healthy baby and reduces the chances of having a birth defect to a large extent. So, if you are planning, these things have to be taken in the counter. Now, the timing of the cycle. Your mid-cycle is the most fertile part. What if you are having smaller or longer cycles. So, we calculate retrospectively. So, supposing you had your menstruation on 1st-Mar if you have a 30 days cycle you are expecting menstruation on 1-Apr, you can't back 14 days or 2 weeks. That comes to around 16-Mar. This is the presumptive date of ovulation.

Now to conceive successfully, you need to understand the life cycle of sperm and ovum. Ovum is alive for 24 hours. Sperm can go up to 3-4 days. There is a very small window period. You need to be in a relationship every alternate day. If you are planning for a pregnancy, certain things you need to have in the account which was as follows. Now, after the age of 35 years, there are certain risk factors which are more lightly to occur. It could be diabetic, rise in blood pressure. Once you are pregnant, there is a risk of developing gestational diabetes, down syndrome. Even if you are pregnant, you should regularly go to the Dr. In a nutshell, I would like to summarize, plan your pregnancy well, take folic acid supplements, have a healthy weight, discuss your medicines and diet with the Dr. Plan your pregnancy according to your desire, stay happy, keep the stress away. Last but not least, Good Luck to all of you!

Hi,

I am Dr. Padmaja Mohan, Gynaecologist. Aaj mai aapse ek bohut hi common topic pe aap se discussion karungi, vaginal discharge. Vagina is a very important part of a female body. It is an organ of passion. We are born out of our mother's womb. We drive sexual pleasure from it. But most of the time, we overlook the problem which is occurring in this part. We have a lot of myths related to vaginal discharge. People will think that any type of vaginal discharge is not normal. Vaginal discharges hone se body se nutrition nikal jata hai. There are many people who will come and meet us OPD and tell they feel a lot of weakness, backache because of vaginal discharges. So, today let me talk a little bit on discharges what is normal and abnormal so that you are aware and if you have any of the problems, you can go to your doctor So, now let's come to vaginal discharge. What is it? Muh me lubrication banana. Ismein good, friendly bacterias hote hain jo humari body ko immunity provide karte hain. Sath hi khane ke pachan mein bhi kaam karte hain. Isi parkar vaginal discharges ek mechanism hai jo humein nature ne provide kiya hai to protect vaina from external bad influences, to prevent it from getting diseases. Vagina ke secretions humare body ke hormones se control hote hain

. And all these hormones are under the influence of the menstrual cycle. So, these discharges will increase or decrease according to the rise and fall of the body. So, you can see your natural discharges will increase prior to menstruation. It can also happen after menstruation, mid-cycle or even when you are sexually excited. How will you find whether this is normal or not? Unknown vaginal discharge will be thin, watery, milky white but will have little odor. Anything which is none of these might be abnormal. Now, what is the composition of the vagina? Where does this vaginal flu arise from? This arises from the secretion of the gland and certain bacteria. So, to have normal discharge is normal and no discharge is abnormal. Vagina mein dryness hona abnormal hai. Vaginal dryness kab hoti hai? Jab humari body mein estrogen hormones kam hone lagte hain. Ye dryness menopause ke around, jo ladies 50-55 saal ki ho jaati hain, unka estrogen decline hone lagta hai ya aap koi aisi medicines kha rahein hai jo estrogen ke against act karti hai, treatment of cancer drugs, especially in the cases where females have breast cancer. Medicines are given at the counteract. Similary, jahan ovaries nikali gayi hoti hain, jinke dwara estrogen production kam ho jaat hai, un cases mein bhi vaginal dryness dekha gaya hai.

Now, we are coming to the 2nd thing. As I have already discussed normal discharge. Let's talk about the color of the discharge. If your discharge is thick, whitish discharge, it is not normal. It is probably due o the fungal infection you are having. It may or may not be associated with itching of vagina, redness, swelling on the private parts. If you have cottage cheese kind of discharge, it is normally because of yeast infection. Greenish discharge is usually because of trichomoniasis. It is a sexually transmitted infection. But discharge which is brownish or reddish in color is also not normal. Iska matlab hai ki andar vagina, cervix or uterus mein kahin se andar se bleeding hai. So, if you have bleeding or brownish discharge, do not take it lightly, go and visit your doctor Most of this vaginal problem are due to sexually transmitted disease. Now, what is it? Ye vo infections hain jo intercourse ke time aap ko transfer ho jaat hai. So, if you have any element of this discharge, you should take your partner along with you to the doctor And discuss the things with doctor Because it is not only you, ho sakta hai ki aap ke partner ko bhi medicines ki jarurat ho. And a very simple way of preventing this problem is use of barriers or condoms. So, in case you are having any of these problems like foul-smelling discharge, thick cheesy discharge, greenish discharge, any itching, bloody discharge, swelling on private parts especially you have acquired after intercourse, please do not take them lightly.

Thank You!