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Ask the Doc
Dr. D. Pushpalatha, Consultant Gynaecologist and Chairperson, Family Welfare Committee, Federation of Obstetric and Gynaecological Societies of India, replies to this week’s queries:
I suffer fom painful periods with heavy bleeding. My gynaecologist has prescribed Lypride Fort injection for three months. She also prescribed premenses, carbofor, wideal. My scan revealed adenomyosis but I had an abortion 10 years ago after which the pain started. It makes me immobile for four days. Also I have become anaemic. Is this injection safe? Can I conceive again? Name withheld
Answer: From your complaints, it is obvious that you are suffering from Endometriosis. Endometriosis is a chronc recurring disease associated with infertility. Your H/O Abortion might have initiated the process. Various theories are there; one of them being retrograde spillage of menstrual blood into peritoneal cavity. The most common complaint is Dysmenorrhoea or painful periods. The medicines being used are not too effective. Consult a good gynaecologist. Diagnostic laparoscopy will indicate severity of the condition. Any endometriotic spots will be burnt. Medicines as Progestrogens or Oral Contraceptive pills are good. Lupride depot has a role to play after destroying the lesions. After treatment the chances of recovery and conception are good.
I am 28 and unmarried. I have had severe menstrual pain and heavy bleeding for the last one year. In April, a pelvic scan revealed chocolate cyst ovaries (5.2 and 5.5 cm) with endometriosis in both ovaries. I was prescribed Tab Duphaston 10 mg for three months. Now I have unbearable pain on the left side, severe abdominal bloating and am unable to move even after the periods. Another pelvic scan showed large cysts (8.2 x 6.4 cm) on the left ovary. Is surgery mandatory? Name withheld
Answer: The diagnosis of Endometriosis and chocolate cysts is correct. The cause is mulifactorial and may have a genetic base. Chocolate cysts are due to abnormal lacation of Endometrial (inner layer of uterus) in ovary or peritoneum. The cysts cannot be treated only with medicines. Laparoscpic excision of cysts and other lesions is the treatment of choice. It is safe and gives good results. It should be followed with Progestogen tabs or Injections and GNRH agonists.
I am a single 44-year-old. Before and after my cycle, which is regular, I suffer from intense migraines for three to five days. During this time my left breast is very painful. My gynaecologist has put me on the pill due to my heavy flow. This has caused an increase in weight despite regular exercise and controlled diet. My family has medical history of stroke and cardiac problems. My weight is 60 kg, height is 154 cm. What is my problem? Ranie Krishnan
Answer: You are passing through a phase known as Perimenopausal syndrome. Due to decreased ovulation,the oestrogen-progesterone levels are low producing vasomotor symptoms, migraine and mastalgia (tenderness in the breast). With your family history, I would suggest the following measures.
Diet: Add fruits that give more antioxidants, which are good in this phase. Also eat more leafy vegetables and salads. Avoid junk food. A healthy menopausal diet not only maintains optimal health but also decreases risk of cardiovascular and osteoprotic changes in the long run.
Exercise: Try a full cardiovascular workup. Exercise like aerobics, walking or Yoga is necessary.
As this is a passing phase, immediate hormone replacement is not needed. Phytoestrogens, which are plant oestrogens found in soya, chickpeas, or as ready capsules will also help. Addition of vitamin A and D and B complex is good. Maintain a positive outlook and stop worrying.
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