Medharbour Multispeciality Hospital

Hello everybody,

I am Dr. Smita Vats. I am a practicing gynecologist. So, today we will be discussing a little bit about family planning. Family planning is important because not only does it help us counterbalance the negative effects of overpopulation, but it also helps a woman be in control of her own life. So, as we know that India is the second most populated country in the world and the ill effects of overpopulation on education, social-economic structure, on overall health and well being of the population are quite well known. So, in order to counter those effects, it is important for women in India to be well informed and well educated about the various family planning options that we have nowadays. So, fortunately, because of the developments of modern science, we have multiple options available, which may suit every kind of a person. And first and foremost, the oral contraceptive pills that we can be using. The only thing is that you need to be careful about while using the oral contraceptive pill is that certain contraindications need to be ruled out before taking them. So you will need to consult your doctor about that and who would prescribe you after checking you up and taking the detailed history. Any history of high blood pressure or having clots in the legs or migraine may not be a good indicator for you to be taking oral contraceptive pills. So these tablets, they have to be taken orally every day, at roughly the same time every day for about three weeks a month. And then there is a pill-free week in which you are not taking any tablet and you usually get your period during that period. So, the important thing to remember while you are taking these tablets is that they have to be taken at the same time.everyday. If at all by any chance you miss one tablet or two tablets in between, make sure that you take tablet as soon as you remember and try not to miss more than one or two tablets during the month. Because that will reduce the contraceptive efficacy and you may end up having a contraceptive failure and being pregnant.

Another option is the Intrauterine devices in which the multi-load that is Copper T or Mirena that is the hormone-releasing intrauterine device may be inserted into the uterus that of course has to be done by the doctor, you can not do it yourself. And these devices act by a sort of introducing certain changes inlining of the uterus so that the pregnancy can not implant there and changes in the cervical mucus also. The hormone-releasing devices also act by releasing hormone progesterone which thins out the lining of the uterus and prevents the pregnancy from happening. The side effects may be that some people are more prone to infections with these and if at all a pregnancy happens while you are having an intrauterine device inside the uterus, you may end up having an ectopic pregnancy, which may be a dangerous situation to be in. Apart from that, there may be other hormonal injections that you can be taking. These injections are usually given once in three months. The side effect is that you may have intermittent spotting or you may not get your periods even after the injection has gone off for some time. So then again it has to be weighed properly in which people are suitable for these injections and who is not. And apart from that the most commonly used contraceptive option is the condom or vaginal diaphragm which are commonly available throughout the country. They again have to be used very carefully and have to be applied before any kind of genital contact is there. Although the failure rate may be higher if they are not properly used they are very convenient to use and have minimum side effects and are suitable for most people. Then of course if somebody has well grown-up children, has more than two children and is very sure that they don't need children, they can go for sterilization operations and such surgeries. But these surgeries usually are considered irreversible and are recommended only if you are really sure that you don't want any further children. And various effects and side effects can be discussed in detail with your doctor and is surely advisable for a person going for the family planning if at all you want to be a good life plan for your life.

Thank you.

Hello everybody,

I am Dr. Smita Vats. I am a practicing gynecologist. So, one of the common questions that we are often asked whether or not they can exercise while they are having periods? So, here I would like to make one statement that although in India the cultural values that we are brought up with, the girls are not usually encouraged to be physically active during their periods. But actually it’s a myth and you should really be as active as you can be during the periods. Because you see not only does it improve the blood circulation throughout your body as well as to your reproductive system but it also improves your core muscles strength, it improves the overall endurance for the pain as well as the threshold for the pain one has. So it helps during the cramps, and pains during the periods to a much better extent as you would have otherwise if you are not exercising. It also helps you get rid of excess water attention in the body by sweating in other means that you have gained during your premenstrual period.

Exercises also supposed to be a very good mood elevator and stress buster because it releases a lot of hormones in the body which are mood elevators and it overall improves your general feeling of well being and helps build up a positive attitude. Having said that, if your body is demanding rest and you feel tired or exhausted, take rest, take a while to recharge your battery and then move ahead. There is no need to over exhaust yourself, push yourself beyond your physical limits. But at the same time, there is no need to be physically, completely inactive during your periods. So, the different kinds of exercises that you can indulge in are light aerobic exercises, swimming, if the flow is not very heavy, you can use menstrual cup or tampon and go for a small lap of swimming, cycling is good, walking on a treadmill is again a very good exercise, yoga is supposed to be a very good exercise, it improves overall oxygen of body, it improves the core muscles of the body, it helps in overall fitness of the body. So, device the kind of exercise that you would want to be doing throughout the month and if you are already doing some sports or some dance or some other physical activity like long tennis or anything else, do continue with that during your periods, it will help you to take the pains better and feel overall better throughout your periods. And if your body demands rest, take rest. So the bottom line is to listen to your body. Push yourself a little bit far but at the same time don’t push it so far. So listen to your body, workout, take rest and be well.

Thank You.

Hello, my name is Dr Smita Vats and I am a consultant Gynaecologist in Gurgaon. Cancer of the cervix is the second most communist cancer of a woman in India every year almost one hundred and twenty thousand women are diagnosed with cervical cancer and out of these almost 67477 women eventually succumb to the disease. So that indicates almost of the mortality of 50% because by the time the diseases diagnosed, it has usually progress to an advance stage. Ironically it is also one of the Cancer for which we have very good screening test available as well as we do have a vaccine available which protect against the development of cervical cancer in most women. The causes of cervical cancer can be many and the most often it is caused by early onset of sexual activity, multiple sexual partners, repeated pelvic infection smoking alcohol but by large the most communist cause of development of cervical cancer is infection with human papillomavirus which is responsible for almost 70% of the cases of cervical cancer. The virus is available in almost is present in almost 100 types of strains and of these almost 15 to 16 types of strains are high risk strains, that is infection with these 16 types of strains will develop will lead to development of cervical cancer in most women who have been infected with these types of strains. The virus is transmitted by sexual activity and as India becomes more and more liberated sexually the younger girls and young women are at a higher risk of developing cervical cancer because they are more vulnerable to the infection with human papillomavirus. The good news is that there is a good vaccine available against the infection from human papillomavirus and it is usually given to young girls between the age of 9 to 15 years of age in the form of two doses even as intramuscular injections 6 months apart. And if the vaccination can also be extended to women up to the age of 26 years in which case, it may be given in the form of 3 doses 0, 1 and 6 months apart and similarly for immuner compromise women the vaccination is also recommended. Beyond the age of 26 years ideally their best method to protect against the cervical cancer is regular screening with Pap smear at maybe 3 yearly interval and if it all it is combined with HPV DNA testing it can done once in 5 years. If the facility for Pap smear or HPV DNA testing is not available then regular periodic examination of the cervix in the form of visual examination by an experienced doctor, also helps in early detection of the disease and prevention of a development of an advanced Cancer. India contributes to almost 25% of the cases of cervical cancer in the world and developed countries like US and UK have been successful in reducing the insolence of cervical Cancer significantly with the development of vaccine and the development of protocols for regular screening by Pap smear and visual examination also. So there is no reason why we in India cannot decrease the incidence of cervical cancer if you follow the regular protocols. So for protection against cervical cancer following basic practices are required to follow safe sexual practices to take early treatment for any kind of vaginal discharge, irregular bleeding or bleeding after intercourse or any kind of abnormal menstrual bleeding. Please visit a gynaecologist on time and a part from these regular Pap smears and HPV DNA testing should be recommended to most women who are sexually active and for any further information you can discuss in details with your gynaecologist or you can send your queries to me through lybrate.com.

Hello, I’m Dr Smita Vats and I’m a practising gynaecologist in Gurgaon from over a decade now. Today, we will be talking about the prevention of fractures and bone health protection in women.

Women form the axis of the basic framework of the society and they are the basic pillars of strength of the healthcare network of the family and the society. Yet they tend to neglect their own health in their daily responsibilities of workplace, and the household duties. It is important to know and understand that bone health is to critical to the day to day quality of life as well as the overall health of the individual. There are certain basic differences between the bone metabolism of men and women and it is important to understand those so that you can take proper care of your bones. This is because after puberty the rate of bone deposition and bone strengthening is faster in men as compared to women and the peak bone mass attained at the age of 25 years is more in men as compared to women. Thereafter, the bone’s mass stays constant in men whereas in women, the additional challenges of pregnancy and breast feeding put an added demand of calcium. If proper calcium supplement does not happen during pregnancy and breast feeding, then the extra demands of calcium of the baby are met through the calcium of the body of the mother and that leads to weakening of the bones, ligaments, and joints, later on in life. Moreover, after the age of fifty, after menopause, the rate of bone resorption and development of osteoporosis in women is much faster as compared to men. So all these factors along with certain lifestyle factors which include physical activity, dietary factors, and the other lifestyle modifications like smoking, alcohol intake etc. does hamper the bone health of an individual and should be looked after.

That brings us to the question as to how to look after the bone health of a woman properly?

First and foremost is the dietary and nutritional factor. Calcium and Vitamin D are the most important nutrients which are responsible for the proper bone strength of the body. Calcium intake, at least one thousand to twelve hundred milligrams per day is recommended. It can be achieved through dietary elements like milk and milk products – yogurt, cheese, curd etc. Apart from egg, meat, mutton, chicken, and other vegetarian products like wheat, raggi, soya bean and fruits and vegetables like black grapes, cauliflower, cabbage, beetroot, pistachio, almonds, all are great sources of calcium. It is important to remember that if the dietary factors do not meet eh regular demands of the body for calcium then one should be taking calcium supplements as prescribed by the doctor, especially during pregnancy and breast feeding women should not neglect the intake of calcium during those times. Apart from calcium, the other important aspect is the Vitamin D intake. The daily requirement of Vitamin D is about two hundred to four hundred international units in a day. The main source of Vitamin D is sunlight and as a result, in the urban population when people are not moving around too much in the sun or whenever they go out they are fully covered or using sunscreen. There is a high incidence of Vitamin D deficiency in this population. Apart from this, people who live in higher altitudes, have a dark skin colour, or are obese also have a risk of Vitamin D deficiency. Hence, such people should be taking Vitamin D supplements as subscribed by the doctor and especially vegetarians because the only dietary source of Vitamin D is through cog liver oil, fish, liver so that leaves very few options for the normal vegetarian population to attain Vitamin D through dietary intake.

Then the other aspect which is very important is the physical activity and regular physical exercise. At least half an hour to forty-five minutes of regular physical exercise is a must. To improve blood circulation and bone health and muscle health in the body. This is also important to improve the overall tone and balance of the body so as to prevent falls and fractures and the risks of injury which may hamper the quality of life in her later age groups. Apart from this, smoking, intake of alcohol etc. can also accelerate bone resorption and also deteriorates your bone health. Hence, it is important to look after all these factors.

For any further queries or any further details, you can send me queries through Lybrate or can meet me personally at my clinic in GNS Hospital or The Gynae Point near South City 2.

Thank you

Here are cause,symptoms and treatments of Polycystic Ovary Syndrome (PCOS)

Hello, I am Dr.Smita Vats and I am a practicing gynecologist at Gurgaon. My areas of specific interest are laparoscopic surgery and dealing with various gynae disorders like Uterine fibroids, Ovarian cysts, Endometriosis, Infertility and high rest pregnancy. So today we will be dealing with a very important disorder which is commonly found in urban population that is the Polycystic Ovarian Syndrome (PCOS). It is a complex disorder which is characterized by the presence of tiny fluid filled cysts in the ovaries which may be present in the one or both the ovaries and is also associated with irregularity of the periods or disturbance in the periods and also the presence of hypergonadism that is the presence of excess of man hormones in the body leading to more of male characters like excess of facial hair , more chest hair, hair on abdomen, thighs, buttocks etc. along with the presence of acne and may be scalp hair loss and this may be associated weight gain also and in the long term later on it may cause also pregnancy complications.

It may cause difficulty in conceiving a pregnancy, it may lead to loss of pregnancies, early abortions and development of diabetes and hyper blood pressure etc., and other complications in the pregnancy, so that it brings to the question that what causes Polycystic Ovarian Syndrome. Well the exact cause of PCOS is not really well known. There is a genetic predisposition for it and the genetic inheritance has been proven. But that does not mean that anybody who does not have genetic predispositions cannot have this disease. So it is a primarily a lifestyle disorder wherein even if you have genetic predispositions the disease usually manifests the signs and symptoms usually appear only when your lifestyle become sedentary. So it is primarily a problem seen in the urban population now-a-days because their lifestyle is sedentary and there is minimal physical activity involved. Now-a-days you spend 8-10 hours sitting in the office on the desk.

Apart from that there is hardly any physical activity. So in order to deal with that, obviously then we have to address the lifestyles also which is the most important factor and sometimes in a few patients a part from lifestyle modifications a few medications may be required which may be decided upon depending on if at all there is a hormonal imbalance or if at all there is any other disorder associated with it which needs to be treated medically. So in the lifestyle modification what you can do is you can include at least half an hour or 45min of rigorous physical activity every day in your routine and if not every day then you can include at least 4-5 days in a week. So include at least 45min of may be walking, jogging or dance, swimming, yoga, or whatever kind of exercise you enjoy. Include at least half an hour or 45min of that kind of physical activity in your daily routine.

Apart from that control your diet, avoid junk food that is avoid chips, burgers, fries, pizzas, high calorie diets and primarily refined foods, white breads and rice and all these things which give you a sudden burst of high calories and which may lead to hormonal imbalance also. Focus more on fresh fruits, fresh vegetables, curds, rice, and milk products whatever low fat milk products. Eat a healthy well balanced diet. A part from that PCOS patients mostly are obese and even a fight person of weight loss whatever their body weight is may lead to improvement of symptoms and help them deal with the disorder and if at all nothing else works then physical managements is required.

If you need any further information or further guidance regarding treatment of PCOS you can contact me on my clinic or online through Lybrate.

Dr. Smita Vats talking about managing pregnancy


Hello I am Dr. Smita Vats and I am a practicing gynecologist at Gurgaon. So my areas of specific interest are gynae- laparoscopic surgeries, treatment of gynae disorders like uterine fibroids, Ovariances, Endometriosis, infertility and high risk pregnancy. So today I will be giving a few suggestions to how to keep cool in summers while you are pregnant. So summers in India can be very hot and bother some time for most people and this version during pregnancy because during pregnancy the basal body temperature is already high and the increased heat and humidity outside can even make you more uncomfortable. Hence it becomes important to take a few steps to maintain your hydration and to keep your well-being during summers.

The first and the foremost thing which is the most important is that you can do to deal with hot weather is to maintain a good amount of liquid intake that is take at least 8-10 glasses of water every day. If it is difficult for you to consume plain water you can maybe add a little bit of mint or lime or slice of orange or whatever you like, whatever kind of flavor that you like to it. And take at least one glass of water for every hour that you are outside in the sun. So whenever you are going out carry a water bottle with you and make sure that you consume at least a glass of water every one hour or so and also minimize your intake of tea, coffee, and other caffeinated drinks because they make your body lose a lot of water as well as salt and electrolytes which can make you dehydrated and make you feel really sick.

Apart from drinking the right things, it is also important to eat right in pregnancy and you should be taking frequent small meals. Avoid very heavy, spicy, and oily food and instead of taking three large meals make sure that you eat a little amount everyone in the half to two hours so that you are not over-eating also and you are comfortable also. Apart from that to deal with heat of the summers make sure that you eat a lot of fruits and vegetables. Juicy fruits watermelon, melon, coconut etcetera, cucumber and all these things which contain a lot of water are a good suggestion for intake during the summer months and just avoid a lot of oily and spicy foods.

Then, when you are going out in the sun make sure that you don’t go out during the very hot part of the day that is between 12 to 4 pm. So plan your outside activities either in the early mornings or in the late evenings. If at all you need to go out in the sun between 12 to 4 pm make sure you keep drinking a lot of water in between and whenever you fell exhausted or you feel dehydrated or you are feeling nauseous or giddy or have any kind of discomfort make sure that you get back into the home, lie down for a while and consume a glass of water or any other liquid and maybe keep a wet cloth on your forehead or something just to make you feel better. If all these things don’t make you feel better than it is the time to contact your doctor and take a proper treatment for that.

For any other regarding pregnancy care, you can contact me at my clinic or at this main online query at the lybrate.com.