Dr. Nupur Gupta's Well Woman Clinic

A mother’s milk is said to be the most nutritious food for a new born baby. It contains the perfect balance of carbohydrates, fats, proteins, vitamins and minerals needed for your baby and changes to keep up with your baby’s growing needs. However, the benefits of breastfeeding extend way beyond nutritional value. Breastfeeding is beneficial for both you and your baby.

Hi,

I am Dr. Nupur Gupta, Gynaecologist. Today I will talk about uterine bleeding. This always happens once in your lifetime and you might need to visit OPD. Its symptoms are irregular bleeding, scanty smell, bleeding during periods, bleeding after menopause and it affects women of all age group. Almost 80% of women in India suffer from abnormal uterine bleeding. As regards to management, there are a lot of medications are available depending upon your age. The medical options are available for pain and bleeding. Medicines are also given with the combination of estrogen and progesterone. If medications are not working properly then surgical options are available. Earlier the most popular once were endometrial ablation, transcervical resection but they have their own limitations. Another major surgery is a hysterectomy, it can be laparoscopic, or it can be an abdominal or vaginal hysterectomy. Other than that the conservative surgical options which have become very popular nowadays in insection of intrauterine device which contains progesterone and it has come to the world over as a magic for the woman who has abnormal uterine bleeding and that is called viremia. It is not only used for abnormal uterine bleeding but also it has a very good contraceptive method.

It is also being used for the woman who has endometriosis. It has been found very useful in women who have heavy bleeding or dysmenorrhea as a contraceptive and women with fibroid who bleed heavily. In such conditions, pain is the biggest concern. As a hormonal contraceptive, it is very good. Because you don't need to take oral contraceptives. It has estrogen so no estrogen side-effects. It is reversible. We need to plan a pregnancy. It has a success rate of almost 90% within 4-6 months of its removal. There are hardly any failure rates associated with it. It thickens the cervical mucus and it also prevents fertilization of the egg with the sperm. As regards the management of menorrhea, it will reduce the lining of the endometrial i.e. thickening of the uterine wall is reduced. It can be done under local anesthesia. Sometimes, it needs to be done under ultrasound guidance. Sometimes there is stenosis of the cervical canal. It looks like a copperT. It has almost 52mg of the hormones progesterone. Sometimes, it is almost negligible as compare to oral hormones that we do for the management of heavy bleeding.

Sometimes, large doses of hormones are required to control the bleeding. In a few cases, low doses of hormones are given because it is active inside the uterine cavity. Its life is almost 5 years after that we need to renew it. There is hardly any pregnancy we have seen after the insertion of this device. In any case, it happens then it becomes ectopic pregnancy. But when it is copperT for 5-10 years, it is more effective. The women who cannot tolerate cooperT, they will have an infection, bleeding, anemia and pain are also concerned and there is the increased risk of infection when we use copperT. The comparison also has been done with hysterectomy which is better technology and which is better for women who have abnormal uterine bleeding. The results for both are almost same. The cost effect is much less as compared to the cost where hysterectomy needs to be done at the same time as the major surgery.

So, it is very good at the age of reproductive not only for contraception but also for managing abnormally uterine bleeding. But we need to keep in mind that its effect will come within 3-6 months of its insertion. You may have an absence of periods for almost 1 year. There might be excess vaginal discharge for some time but all this can be managed. The reduction in pain is almost 80% at the end of 2 years. The satisfaction rate is very high. Sometimes expansion rate is very high for the women who have a uterine cavity. So, we have to be very choosy who is the right candidate for this insertion. It is usually a painless procedure we operate in our OPD. So to conclude, I would like to say you must give it an option and you must find out whether it will suit you or not. Your life will become very easy. For any further query, you can consult me through Lybrate.

Thank You.

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Lybrate - Dr.Nupur Gupta talks about Cervical Cancer.

Hello I am Dr. Nupur Gupta consultant gynecologist and obstetrician practicing in Gurgaon. Today I am going to talk about cervical cancer and its prevention. We all know it is one of the very common cancers amongst females all over the world especially in developing countries, it is more common in developed countries because of poor maternal health. The patients don’t want to go to the gynecologist. There are no guidelines which they know about and they can go for screening for cancer. There are various symptoms that women should know that how cervical cancer can be diagnosed and when is the right time for them to report to their gynecologist. Especially with women, it can happen at any age and especially women who are sexually active with multiple sexual partners who have been infected with human papillomavirus at some point during their life and who have irregular vaginal bleeding and who have bleeding after intercourse which is called Postcoital bleeding and who have intermenstrual bleeding or sometimes they have foul smelling and vaginal discharge. These are all the symptoms which should prompt any female in reproductive age or during menopause, postmenopause to come to a gynecologist and go for screening.

There are various guidelines which are developed in UK, in US and over world and especially in India for females. When should Pap smear be done in any female, is every three years after three samples are negative in three consecutive years. After the age of 60 to 65 years we do it every five years and so on. So women don’t need to fear about cervical cancer anymore because now-a-days research has led to development of a new vaccine, a new innovation in health care which is vaccine against human papillomavirus which leads to this kind of cancer in females. It can be given to adolescent girls from nine years of age onwards and now-a-days it is also part of Indian Academy of Pediatrics immunization in India.

In some countries even boys are given this vaccine because this virus is known to be transmitted from male to female. Upto 26 years of age, any women is eligible to take the vaccine and also women above 26 but who are not sexually active and never had intercourse till date. But taking the immunization doesn’t mean that Pap smear need not be done, still Pap smear screening is mandatory to detect cervical cancer as far as possible. So now we know that cervical cancer is preventable and there is a vaccine which is available, there is Pap smear that can be done in women who are sexually active.

So if you want to know more about this cancer and prevent yourself being affected by this kind of cancer and go for screening you can consult me on lybrate.com which has all modes of consultation audio, video or a text mode of consultation.