1. R. M. Oman
* I am 27 years of age. I am having the problem of poly cystic ovarian syndrome. I am married for three years. I have taken lot of medicines, but I have not yet conceived. I have irregular periods. My doctor has asked me to be strict on diet; to avoid dinner and to be on green salads. I take green tea; I do not take meat and sweets. But still my periods are irregular. The doctor had performed ultrasound scan and is of the opinion that I was not ovulating. I want to conceive. What may have to be done?
** The problems expressed by you including failure to ovulate and conceive are related to poly cystic ovarian syndrome. The poly cystic ovarian syndrome (PCOS) or Stein- Leventhal syndrome is a condition in which there is an association between the presence of polycystic ovaries and signs of hirsutism, amenorrhea or oligomenorrhea and obesity. In this syndrome, other than an ovarian defect there can be biochemical, clinical, and endocrinologic abnormalities. Although the condition is now referred to as polycystic ovary syndrome (PCOS) it may occur in women without ovarian cysts. Women with PCOS have abnormalities in the metabolism of androgens and estrogen and in the control of androgen production. High serum concentrations of androgenic hormones also may be encountered in these patients. PCOS is not a rare problem and approximately 6-10% of women in the developed countries have PCOS.
The extent of the problems associated with PCOS varies from woman to woman. However, there is effective treatment for the condition and it depends on the problems the individual has. Many of these women are able to conceive if the abnormalities are set right. The treatment can be medical with varieties of drugs- certain anti-diabetic agents like metformin, oral contraceptives etc. Other than medication, weight reduction, diet and exercises also are the part of treatment. The diet advised by your doctor might help you to reduce the weight, if you are over-weight. It will not set right the hormonal abnormalities. You may require specific treatment for the problem. You may consult either an endocrinologist or a gynecologist for proper treatment.
2. A.D’S, Dubai
* I am 28 years of age. I am married since 4 years and seriously trying for a baby since 2 years without any positive result. I have regular periods, normal BMI and no health issues. I had even done follicular study and checked my ovulation pattern which was very normal (around 13-17th day). However, lately my doctor pointed out to me that my endometrium thickness was on the lower side. During ovulation it was around 6.3 she said it needs to be around 7.5 for conception. Is there any treatment that could help me solve this issue? Is it that with low endometrium walls that I am not able to conceive?
**The endometrial thickness is often a matter of concern during artificial conception treatments or IVF cycle. Its role in natural conception is not well reported. There is strong data to show that there is a trend towards higher pregnancy rates (in IVF) with thicker endometrium, but there is not a definitive lower or upper threshold where pregnancy does not occur. However, in many instances, there are few interventions or treatments that will alter the thickness within a patient. The thickness is primarily dependent on estrogen levels, but estrogen levels are well above physiologic levels during an IVF cycle, so adding estrogen is rarely going to help. It means to say that there is nothing that may be done to increase the endometrial thickness. You may discuss this issue with your gynecologist and find out if there are any other solutions for this.
3. J.R. Mangalore
* I am 23 years of age. I am married for 3 years. I conceived within a month of marriage, I conceived, but I underwent abortion. After 5 months of marriage, I came to know that my husband was HIV positive. I got checked and was negative, even 6 months after also I was negative. I have not got the infection. Can I go for pregnancy again?
** You should thank your stars that you did not acquire infection in spite of your husband being HIV positive. It is true that every sexual act with an infected person may not transmit the virus, but it is not possible to predict which one will do. The estimates suggest that the rate of heterosexual transmission of HIV per instance of vaginal sex follows a ‘U’-shaped model, with transmission being highest soon around the period of HIV seroconversion, that is early in infection, lower during chronic infection before increasing again during late-stage HIV infection. This model is supported by analysis of HIV plasma viral load, which is highest during early and late HIV disease and has shown to be a predictor of the risk of heterosexual HIV transmission.
However it may be prudent not to take chance, you and the baby both might acquire infection if you continue to have physical union with the infected man. Let your husband take proper treatment (available free of cost in government hospitals) so that the disease may be postponed. For your safety, do not have any type of sexual contact with him.
4. R. D’S, Bangalore
* I am a 31 years of age. I have a round black colored smooth raised 'mole or cyst' (do not know the exact word, but it looks like filled with fluid or small pea, not very clear) on the inner side of labia majora. It is present since 2 years (I think started after intercourse). It was small in the beginning and once I tried to squeeze it the blood started dropping and from then I am noticing it has grown a little big (may be size of a pimple). I did not notice any changes in the size or color thereafter but it is itchy sometime. Could you please let me know is it something to do with cancer or any kind of infection or sexually transmitted disease? What are the signs of a cancer?
** By the description given by you, it appears that you are having a condition known as Bartholin’s Cyst. This is not a sexually acquired disease and not a condition that can lead to cancer. The Bartholin's glands are located at the entrance to a woman's vagina, one on each side. They are small and cannot be seen or felt when they are normal. Their function is to secrete fluid onto the mucosal (inner) surface of the labia-the liplike skin surrounding the vagina. Problems with the Bartholin's glands include cysts, which are relatively painless enlargements of the gland, and abscesses, which are infections of the gland. Typically only one of the two glands is affected.
A Bartholin's cyst develops when the duct exiting the Bartholin's gland becomes blocked. The fluid produced by the gland then accumulates, causing the gland to swell and form a cyst. An abscess occurs when a cyst becomes infected. A Bartholin's cyst causes swelling of the labia on one side, near the entrance to the vagina. A cyst is usually not very painful, and significant pain suggests that an abscess has developed. (Infected cyst is painful where as the plain cyst may not cause any pain) However, large cysts may be painful simply by virtue of their size. The Bartholin’s Cysts are usually harmless and may not require treatment. With Bartholin's cysts and abscesses, the primary reason to seek emergency care is acute pain. Women who are experiencing severe pain or who cannot sit or walk comfortably should see a gynecologist.
5. P.D’S, Dubai
*My wife is 27years of age, same as mine, married for two and half years. We are trying for a baby for the last 6 months but not been successful till now. Her periods are regular last for 5-6 days a 29-30 days cycle. We have consulted gynecologist. She had asked us to undergo few tests. Firstly she had asked us to have intercourse and visit her within two hours to check if the sperms are active. This test was positive. She said there was no problem with me; next doctor advised us to have intercourse on the peak days. She examined my wife on the 11th day to see if there was ovulation, she said the eggs size was small & it had to be bigger in size during ovulation. My wife was asked to have clomid on 2nd day of next period for 5 days and asked to have intercourse on peak days. Even then we were not successful even after ovulating. Next doctor asked us to undergo tube patency test (HSG). The nurse mentioned that this test would be little painful as they would insert a dye inside fallopian tube to check if they were blocked or open. We had checked in net about the test and we found that this test could be harmful. It can damage uterus. Is there any other way of treatment to conceive? What are the chances of getting pregnant even if my wife takes tube test which was advised?
** You seem to be wrongly informed about the HSG test. A hysterosalpingogram (HSG) is an X-ray test that looks at the inside of the uterus and fallopian tubes and the area around them. It often is done for women who are having a hard time becoming pregnant (infertile). During a hysterosalpingogram test, a dye is put through a thin tube that is put through the vagina and into the uterus. Because the uterus and the fallopian tubes are hooked together, the dye will flow into the fallopian tubes. Pictures are taken using a steady beam of X-ray as the dye passes through the uterus and fallopian tubes. The pictures can show problems such as an injury or abnormal structure of the uterus or fallopian tubes, or a blockage that would prevent an egg moving through a fallopian tube to the uterus. A blockage also could prevent sperm from moving into a fallopian tube and joining (fertilizing) an egg. A hysterosalpingogram also may find problems on the inside of the uterus that prevent a fertilized egg from attaching (implanting) to the uterine wall. The hysterosalpingogram study only takes about 5 minutes to perform. However, the test is usually done in the radiology department of a hospital.
Complications associated with a hysterosalpingogram include the possibility of an allergic reaction to the dye, which is uncommon. This usually causes a rash, but can rarely be more serious. Pelvic infection or uterine perforations are also possible complications, but these are very uncommon. Your wife may opt for the test as suggested by your doctor.
6. F. D’S, KSA
* I am 40 years of age. I get burning sensation in my sex organ after passing urine. This happens while passing urine and same problem after sexual intercourse. I also find white colored thin deposits under the foreskin. If I clean next day it again accumulates. Can you please suggest me what is the reason for this and whom shall I consult?
** You might be having the infection of the urinary tract as well the glans. Consult either an urologist. A simple urine test may reveal the problem. The infection can be treated with appropriate medicines taken orally and also some ointments that are used locally where you get the white deposits.
7. K.M.S. Udupi
*I am 30 years of age and married for 3 months now. We are planning to have a baby as soon as possible. My wife washes her private part soon after having sex. Will this affect the chances of conceiving?
** Simple washing the private parts after sexual union may not affect the conception. During physical union the semen is deposited deep inside the vagina and normal cleaning will not wipe out the sperms from there.
8. I. A. Mangalore
* I am 48 years of age. I have undergone angioplasty about 4 months ago. The doctor had told me thee were two blocks. Now I am taking five tablets daily. Is there any restriction to have physical relation with my wife?
** By angioplasty the blocked arteries are opened and the heart muscles get better blood flow than before. By this the heart can tolerate more stress. Hence the person can have more vigorous sex than before, though the vigor is not dependent on heart. One can have normal sexual activity soon after angioplasty.
9. V.N. Kundapur
* I am 23 years of age. I have the problem of excessive sweating in my hands. How to avoid this?
** Excessive sweating or hyperhidrosis is a clinical condition where parts of the body are sweating beyond the body needs. It is commonly an inherited condition. A segment of the sympathetic nervous system is responsible for this presentation. The sympathetic is an autonomous part of the nervous system on which we have no control. (The autonomous nervous system has two parts to it, the sympathetic and the parasympathetic. Those systems affect blood pressure, heart rate, anxiety level and many other functions)
Commonly affected areas of the body are the hands, and feet. In smaller groups of patients the facial and armpit areas are affected as well. Excessive hand sweating or as palmar hyperhidrosis is the most common form of excessive sweating. Attempts to control this condition are numerous and they range from lotions, pills, herbal medications, bio feedback, electric currents (iontophoresis), and acupuncture etc and. to surgery. The benefits of these various modes of management are limited and in some they may not help at all.
In some centres endoscopic thoracic sympathectomy (ETS) is performed to relieve excess sweating in selected individuals. This operation is carried out in a relatively short period of time and the amount of pain and discomfort is limited. Benefits of the surgery are to be discussed with the surgeon before opting for it.
To answer in brief, there is no definitive treatment to halt or to reduce the problem of excess sweating.
10. S. F. Mangalore
* I am 25 years of age. I have the problem of panic attacks. After the treatment of psychiatrist I am slowly getting well but the problem is now I am having only half tablet to be taken daily. If I discontinue it I feel like vibration and my mood also gets disturbed. Please let me know how can I stop this tablet for psychiatric problem?
** Panic attacks are frightening but fortunately physically harmless episodes. They can occur at random or after a person is exposed to various events that may trigger a panic attack. They peak in intensity very rapidly and go away with or without medical help. About 5% of the population will experience panic attacks during their lifetimes. People who have repeated attacks require further evaluation from a mental-health professional. The frequent panic attacks may be symptoms of an anxiety disorder and affect at least 20% of adults. Once someone has had a panic attack, he or she may develop irrational fears, called phobias, about the situations they are in during the attacks and begin to avoid them. That, in turn, may reach the point where the mere idea of doing things that preceded the first panic attack triggers terror or dread of future panic attacks. For example an individual can have the panic disorder being unable to drive or even step out of the house. If this occurs, the person is considered to have panic disorder with agoraphobia.
Once the diagnosis of panic attack is made, the person requires further evaluation by a mental-health professional to check for the presence of other mental-health disorders. These may include anxiety disorders, depression, or panic disorder (a different diagnosis than panic attack). There are several types of drugs that may help to relieve the problem. These have to be continued as per the advice of the mental health worker.
Do not stop the medicine or alter the dosage unless you are advised to do so by your doctor.
11. M.D’S, Dubai
*I am 26 years of age, married. I get my periods on 20th of every month & it lasts till 23rd of the month (4 days). Please advise me, which are the safe days to have sex to avoid pregnancy without using any barriers like condoms or tablets?
** Normally a healthy woman with regular periods will have ovulation on the 14th day preceding the day of onset of menstruation. Two days preceding it and two days following it are termed as the ‘window of fertility’.
Window of fertility is the most likely period of ovulation and it is commonly advised for infertile couple to make use of, the chances of conception are better in this period. Most of the couple is advised to practice this at least 6 months before opting for costly tests of infertility and artificial methods as treatment. The incidences of conception are more if physical union is regularly performed during window of fertility. However this is not a guaranteed method.
As stated by you, your periods normally start on 23rd of each month and 14 days prior to that, that is 9th of each month is the fertile day and 7th to 11th are considered as the window of fertility. All the days of month, except from 7th to 11th may be safe in your case.
But the calculation regarding the fertile period (5days) is not always true. It varies from woman to woman and may vary in the same woman from month to month. This is due to variable survival period of sperm in female genital tract after intercourse as well as the survival of egg after the ovulation. So in theory, middle 2 weeks are fertile and 1st and last weeks are 'Infertile'. Having said that, even if you follow this safe period (1st & last week of your cycle), this method has high failure rate. This is because, apart from reason mentioned above (survival time of egg and sperm), also there is large variation of ovulation timing in each cycle. Therefore this method is not normally recommended for effective family planning. In fact safe period can be highly unsafe!
12. W.A. Mangalore
* I am 43 years of age. I underwent an operation for hernia on both the sides two years ago. Whenever I do exercises and during long walk pain is recurring. Please advise whether it is safe to do exercises?
** You may consult the surgeon who had operated on you to be sure that there are no problems of recurrence. If there are no problems related to surgery, you may do specific exercises to strengthen the muscles of your abdomen. Either your surgeon will teach you these or you may consult a physiotherapist.
13. M.D’S, Mangalore
* I am 28 years of age. I am planning to get married soon. But my penis is completely bent up to 45degree to the right and while I urinate the urine will spill out on my right leg unless I hold the organ. I am also having the habit of masturbation since the age of 15. Will these problems affect my married sex life?
** Normally the male organ is not straight and slight amount of bent is normal. Some are curved up, some down, some left, some right, and some don't curve at all. All of these are considered normal and unless are causing difficulty to the person to have sex, do not need any form of treatment. Masturbation no way affects the size, shape or the bent of the penis.
In some rare cases the curve can be pathological. In a condition known as Peyronie's disease the curvature may be severe. The penis can bend severely left, right, up or down, or even back on itself, making intercourse impossible. In Peyronie's disease, the elastic tissue of the tunica is replaced by scar tissue. The disease starts as a small bump or constriction on the shaft of the penis below the skin, which expands to form a flat deposit that's sometimes as large as the diameter of a coin. When a man with Peyronie's has an erection, the plaque does not expand, so the penis curves.
You may consult an urologist to make sure that the bent is not pathological. If it is due to Pyeronie’s disease the doctor will suggest you appropriate treatment.
14. D. M. Mysore
* I am a lady of 22 years. I have the habit of masturbation. Does the habit of masturbation in girls/ladies affect their sex organ or sex life?
** Like in men, the habit of masturbation is no way bad for women. When woman masturbates, it can relieve menstrual cramps, relieve stress and tension, make her feel more confident about herself, allows her to discover how her body functions to climax, and many more! There is no time that masturbation is not good for a woman.
15. S.R. Sharjah
* I am 26 years of age. I wanted to know whether the so called height enhancers available in the market like herbal body growth formula do they live up to their promises or at least cause a substantial height growth if not huge; and are there any side effects of taking the same?
** The height of an individual is genetically determined and there is no medicine in any system that can alter it. In a healthy individual the pre-determined height is attained once the growth is completed, in men it is around 21 years and in women it is around 18 years. Ayurveda is also a system of medicine which is studied in ayurvedic medical institutions in our country. If there were medicines to enhance the growth, they would have been widely available with ayurvedic doctors. The claims by certain advertisers that their medicines cure incurable diseases or alter dimensions of the body parts like height of an individual or size of the breasts or penis is hoax. These people cheat the gullible customers, who probably curse their fate for not attaining the effect of the medicine as claimed in the advertisement; in fact the medicine itself is of no use.
16. F.N. Abu Dhabi
* I am 24 years of age. I want to become strong sexually. Which are the best tablets, without side effects, which can make the sex organ in men long and strong?
** Normal diet, regular exercises like walking, swimming and adequate sleep which is required for the healthy body is sufficient to make a man physically as well as sexually strong. There are no medicines which can alter the size, shape or the strength of the sexual organ. In fact there is nothing like ‘strength’ as far as sex organ is considered. In our body the strength of a part is because of the muscles, but unfortunately sex organs are not made of muscles!
17. S.S. Mangalore
* I am 27 years of age. I always feel stressed and exhausted. I can not do any hard work. Even I can not do sex for long time. Please let me know what may be done?
** You may consult a physician and find out why you feel exhausted or weak. Some underlying conditions like anemia or some hidden disease like tuberculosis may cause exhaustion or weakness. If there are no physical causes it may be because of your mental make up and the doctor might refer you to counselor for proper advice.
18. M.P. Mangalore
*My daughter who is 3years is having vaginal discharge from one week. Whether this is normal?
** It is not normal in small children to have discharge from the vagina. You may consult the pediatrician or a gynecologist for proper evaluation. Discharge normally indicates inflammation either because of infection or trauma.
19. E.R. Mangalore
* I am 36 years. I missed my periods for 2 months and I am not pregnant. What may be the cause?
** It is not uncommon for women of your age to miss periods for no definite reason. In some women who are in pre-menopausal years irregularity in periods may be the only symptom. Premenopause, often referred to as perimenopause, is the phase in a woman’s life just before the onset of menopause, which is when a female’s menstrual cycle permanently ceases. The average age for a woman to experience premenopausal symptoms is 45, but women as young as 35 may exhibit signs of premenopause. The length of premenopause varies from woman to woman, but typically lasts from one to six years.
During premenopause, a woman’s hormones production begins fluctuating and declining, which can cause a wide variety of symptoms. A majority of premenopausal women experience changes in their menstrual cycle. As a woman’s estrogen levels begin to decline, the menstrual cycle may shorten, causing more frequent periods. However, some women begin to have longer cycles and less frequent periods. Some women even skip periods.
You may consult a gynaecologist for further evaluation.
20. N.S. Mangalore
* I am 23 years of age. My belly is protruding and I look like aged. I am working as an accountant. Is my job is the cause for the problem? What may be done?
** Unhealthy eating habits, lack of exercise, and rarely ailments related to the digestive system and bowel movement are the causes for the appearance of a pot-shaped belly. The excess deposit of fat in the abdominal region, due to over weight or obesity is another reason for the irregularity in the shape of the tummy. Regular exercises and a proper diet plan can help in reducing the pot belly.
Take care of the eating habits: Instead of having three heavy meals a day, consider eating five smaller meals. Avoid having snacks in-between the meals. Consume smaller doses of what you eat usually. Start the day with a healthy breakfast and end with a light supper, three hours prior to bed. Make sure that you do not skip your meals. The right choice of food: In many of the men the fat gets accumulated in the abdominal wall and it is the main reason of pot belly. Reducing the high calorie food stuffs like oily and fried food items, meat and meat products and having a diet rich in vegetables and fruits may help you reduce your weight as well as your belly. However if you find that excess gas formation is the reason for the appearance of the tummy, you may eliminate the food items that promote it. Vegetables like cabbage, broccoli, cauliflower and onions are found to promote the formation of gas, leading to a protruding tummy. You should concentrate on the food items that are best for your health and will help you get rid of the pot belly.
Fiber in the diet: Chronic constipation and lack of regular bowel movements may also contribute to the appearance of a pot belly. In such case, one should include fibrous food in the diet. The fibrous food such as whole grains bread, green leafs, vegetables and fruits are good for health as well as to get rid off constipation. The fiber in the food stuff will help promote the smooth movement of bowel, which will, in turn, flatten the tummy.
Plenty of water: An adult should drink at least eight glasses of water in a day. Keeping oneself hydrated will promote the smooth bowel movement. The fresh fruit and vegetable juices are good but not the sugary drinks.
Weight reducing program: The excessive fat storage in the abdominal region of the body is the underlying reason for a pot belly. Aerobics can help a great deal in loosing the pot belly. Walking brisk, cycling or swimming or playing games like tennis help in burning extra fat around the abdomen. Any exercise that helps you to breathe well and makes you to sweat is good for your health as well as to lose weight.
Exercise: Exercising daily is a must to flatten the tummy. The workouts that are concentrated on the lower and upper abdominal muscles are good for strengthening the muscles. Such exercises will not only help to get rid of the pot belly, but also strengthen the abdominal muscles. The exercises should be on a daily basis and must be a routine to get the best results. You may consult a physical trainer or a physiotherapist about the exercises that suit best to your body structure.
21. A. M. Chennai
* I am 53 years of age. I have the problem of hernia for the last 3 years. Can this be cured without surgery?
** An inguinal hernia occurs when a loop of intestine or omentum, the covering layer of the intestines enters the inguinal canal in the groin area, between the pubis and the top of the leg. The protruding intestine or omentum goes through the lower layers of the weakened abdominal wall and creates a lump. Inguinal hernias are the most common type of hernia, accounting for 70 per cent of all hernia cases. Men are 10 times more likely than women to get an inguinal hernia. Treatment is important to avoid a potentially serious condition called a strangulated hernia. This is when the bulging through the muscle wall obstructs the flow of blood to the intestine or stops the flow of intestinal contents, leading to tissue death. This is an emergency situation and unless treated promptly, it can lead to fatal complications.
For the inguinal hernia the only treatment is surgery and there is no other treatment to cure this problem. The segment of bowel is put back in the abdominal cavity and the muscle is closed. A piece of plastic mesh is sometimes used to reinforce the weakened muscle area. About one in 10 inguinal hernia sufferers may have to have a hernia repaired again. These recurrent inguinal hernias are usually the result of trauma to the operation site or to poor tissue healing.
22. P.K. Bantwal
*I am 31 years of age. I had an unexpected water break and delivered my baby at 30+ weeks and subsequently lost him due to PDA. Do you think I have a high risk of same thing happening next time?
** No. These types of complications are rare and they normally do not recur. The baby must have died due to the complications of PDA, which is unlikely to occur in subsequent pregnancies.
23. L.C. Kuwait
* I am 34 years old, having child of 10 years and trying for another child for the last 2 years, but not conceived again. My gynecologist informed me that I was ovulating and my eggs were releasing, but I have no mucus in the ovulating period, so feeling dry and physical union is hard. My gynecologist did the HSG test, to see whether the tubes are blocked, but tubes also alright, but I am not conceiving. Sometime I use KY JELLY for easier union, my question is whether this jelly is creating problem to conceive again? I want to increase my mucus, so please let me know the ways to increase the mucus?
** The most common reason of inadequate lubrication is inadequate foreplay. Vaginal lubrication also depends on the level of estrogen in the body. The vaginal mucosa is probably more sensitive to variations in estrogen levels than the uterine endometrium. Many women may have this problem when they are in pre-menopausal age. Inadequate foreplay being the main cause for vaginal dryness, there can be some other causes. Other reasons for vaginal dryness before the menopause can be linked to hygiene products such as feminine sprays and harsh soaps, swimming pool and hot tub chemicals and some washing powders. Certain drug treatments such as allergy and cold medications and some antidepressants, can also dry out mucous membranes, including vaginal tissues. It is common at your age to have dry feeling which might be related to low hormonal levels. Again the hormonal imbalance affects the growth of the egg in the ovary and can be the cause for failure of conception. You may discuss this with your gynecologist and find a proper solution. However the use of lubricants like K-Y jelly may not interfere with conception.
24. M.L. Dubai
* I am 40 years of age. During a routine breast scan result a small hypo echoic lesion was found in the right breast 9 to 10 o'clock position, likely intraparenchymal lymph node and also a small fibroadenoma left breast 2 o'clock position. The doctor has prescribed some medicine for this. Should I get it checked again after 6 months? What is intraparenchymal lymph node means?
** A lymph node is a small ball-shaped organ of the defense mechanism of the body known as immune system, distributed widely throughout the body including the armpits, breasts, stomach/gut etc. They are linked one another by tiny tubules known as lymphatic vessels. Lymph nodes are found all through the body, and act as filters or traps for foreign particles. They are important in the proper functioning of the immune system. The lymph nodes found inside the tissue are known as intra-parenchymal lymph nodes. The intra-parenchymal lymph nodes in breasts suggest that the lypmh nodes are inside the breast tissue. They are normal.
Your scan reports are normal. It may be better to have the breast scan once in a year so as to detect any changes at the very beginning.