Women of reproductive age may choose to practise family planning for various reasons. Keeping the societal judgments aside, contraception protects a woman from unwanted Pregnancy. Pregnancy may also be a health risk in some cases. Specific methods also pose substantial barriers against sexually transmitted diseases. Common advice from doctors are:

Temporary methods

• Contraceptive pills
• Intrauterine Devices (IUDs)
• Implants
• Condoms

Permanent methods

• Tubal ligation
• Vasectomy (surgical method in males)

During Pregnancy, a woman needs care. A solid supportive partner, friends, family, and a team of healthcare providers, just like the old saying, “It takes a village…”, to birth and raise a child.

Regular medical appointments vary with the pregnancy stage. The doctor checks on your condition and the foetal progress. A rough plan may be as follows:

• Once a month in the first six months or more, depending on your condition
• Every two weeks in the 7th and 8th months
• Every week during the 9th month

Your visits may include:

• Routine tests (blood test for anaemia, HIV, blood typing)
• Monitoring for

• Blood Pressure
• Weight gain
• Foetal growth and heart rate
• Foetal Echocardiography
• If you choose to seek nutrition counsel, a dietician will advise you on a diet. Physiotherapists help with backaches and exercises to improve fitness and maintain a healthy weight.

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A new mother needs care as much as a mother-to-be. The postpartum or postnatal phase begins after the childbirth and continues until the body has almost returned to the pre-pregnant state. Postpartum can last 6 to 8 weeks.

As a new mother, you learn new responsibility and care for your young one entirely dependent on you. Your body has changed, and your life is changing in so many ways, that things may feel a little overwhelming. Talk to your doctor. Ask for mental health counselling if you feel the need. Work on your physical fitness. Build up your strength. Eat well. Your baby continues to need and get the nutrition from you through breastmilk. Get ample rest. You need and deserve it. Our doctor will also have that “Talk” with your partner.

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Endometrium tissues line the uterine walls. Sometimes, a similar lining grows in other organs in the pelvic region like ovaries, fallopian tubes or beyond; it is a painful condition called Endometriosis. Like the uterine lining, this tissue also thickens and then sheds in menstrual cycles but has no exit. In ovaries, they become cysts and irritate the surrounding tissues to cause scarring inside.
This is a life-long situation with a huge impact on general and reproductive health. Unfortunately, not everybody experiences symptoms of Endometriosis, making it difficult to diagnose.

Symptoms:
Lower abdomen or pelvic area Pain

• worse during menstruation
• during or after intercourse
• during bowel movement or urination

Nausea, bloating, fatigue, constipation, diarrhoea during menstruation
Heavy menstrual bleeding or mid-cycle (intermenstrual bleeding)
In some women, depression requires mental health counselling

The symptoms are similar to pelvic inflammatory disease or ovarian cysts, or even Irritable Bowel Syndrome (IBS), it’s a challenge to diagnose Endometriosis. Infertility is most often the reason a doctor checks for this condition. IBS may be an accompanying disorder in some cases.

See your family physician or gynaecologist if you experience any of the symptoms listed above. While Endometriosis is not curable, timely intervention can relieve a person from physical and emotional pain.

These are noncancerous tumours, single or clustered, small or large (1 mm to 8 inches in diameter or more), and grow in or on the uterus. Fibroids are not uncommon but remain largely undiagnosed as they may or may not induce symptoms similar to Endometriosis. Some risk factors are obesity, family history, early menstrual onset age, delayed menopause.

Symptoms:

• Excessive bleeding
• Painful menstruation
• Intermenstrual bleeding
• Bloating
• Frequent urination (fibroids adding pressure on the bladder)
• Pain during intercourse
• Low back pain
• Constipation
• Chronic vaginal discharge
• Inability to urinate or emptying the bladder completely
• Abdominal enlargement (abdomen may seem similar to Pregnancy)

Anaemia in women has been associated with Fibroids responsible for causing excessive bleeding.
The doctor may order these procedures for diagnosis:

• Ultrasonography
• Magnetic resonance imaging (MRI)
• Computed tomography (CT)
• Hysteroscopy
• Hysterosalpingography (HSG)
• Sono-hysterography
• Laparoscopy

Women can get pregnant even if they have Fibroids but may face complications during delivery, leading to C-section. In addition, fibroids have been observed to alter in size over time with hormonal levels. In some women, they have reportedly shrunk after menopause.

A woman goes through menopause, perimenopause and post-menopause phases during the twilight years of her reproductive age. She starts with Perimenopause, 8-10 years before menopause, the point when she doesn’t have a menstrual bleed for a minimum of 12 months. The cycle ends at post-menopause. The entire event may start in the 40s but in some women, it begins in the late 30s.

The phase-wise transition of the menstrual cycle engenders symptoms like:

• Reduction in the frequency of menstruation
• Change in bleeding flow (heavier or lighter than regular)
• Hot flashes (reportedly 75% of women experience it), night sweats, flushing
• Insomnia
• Weight gain
• Depression, anxiety, concentration and memory problems
• Vaginal dryness, reduced libido, or sex drive
• Dry skin, mouth, and eyes
• Increased urination
• Headaches
• Urinary tract infections (UTIs)
• Reduced muscle mass
• Painful or stiff joints
• Reduced bone mass
• Hair thinning or loss

And many more.
Doctors prescribe hormonal assessments to confirm menopause when women present a combination of these symptoms.

Common hormonal assessments:
Follicle-stimulating hormone (FSH) level elevates near menopause
Oestradiol level to check oestrogen production rate in the ovaries
Thyroid hormones to prevent thyroid gland disorders which are known to cause symptoms resembling menopause
Anti-Mullerian hormone (AMH) created in the reproductive tissues checked for a reserve of eggs in the ovaries

The menopause phenomenon has a substantial physiological and emotional impact on a woman’s life. A doctor can help you deal with it medically and advise counselling to better manage your mental health and sleep pattern.

Osteoporosis is the name of the disorder in which the bone becomes weak and breakable. Women from the Asian continent who are past their menopausal phase have been known to have a significant risk of developing osteoporosis.

Women of 40 and above should see a doctor if they present with signs like prolonged back pain, fractured or collapsed vertebra, loss of height over time, stooped posture, easy breaks of bones than expected. It’s not easy to know if you have osteoporosis, so better talk to your doctor.

Some causes of osteoporosis are:

• Low oestrogen levels, one of the most substantial risk factors
• Treatments for breast cancer
• Hyperthyroidism or hormonal therapy that increases levels
• Overactive parathyroid and adrenal glands.
• Low calcium intake
• Underweight
• Celiac disease
• Inflammatory bowel disease
• Kidney or liver disease
• Cancer
• Lupus
• Multiple myeloma
• Rheumatoid arthritis
• Lifestyle choices
• Gastrointestinal surgery
• Steroids and certain other medications
• Complications

Your doctor will recommend dietary changes and supplements for elements that increase calcium uptake by the system. In addition, exercises, avoiding substances or drug abuse, and other factors can help manage the condition.

Early screening for breast and cervical cancer is the best way to ensure timely intervention and the best possible outcome (CDC).

Breast Cancer:

• Sono-Mammograms to look for suspicious lumps or tissue growths

Cervical Cancer

Adolescent & Young Adults

• Pap test to detect cancerous cells in the cervix
• HPV test for the presence of human papillomavirus that causes cervical cancer

According to your age group, the doctor will advise health check packages that cover cancer screening and more and help your medical team plan early intervention should there be a need.

Most common are irregular menstruation and dysmenorrhoea or pain. Pain during periods is a genuine thing and not a myth, as many seem to continue believing. It’s also associated with nausea, bloating, overall unwell feeling, and mood swings.

Dysmenorrhoea is associated with:

• Severe cramps
• Bouts of sharp pain in the lower abdomen, lower back and thighs
• Sweating
• Fatigue
• Headache
• Dizziness
• Nausea (with or without vomiting)
• Diarrhoea

Irregular menstrual bleeding is also known as dysfunctional uterine bleeding and require medical attention. The cycle may:

• Have less than a 21-day interval (counting from day 1 of one period to that of the next)
• Have interval of 35-42 days
• Run longer than 7 days

The doctor may perform a physical examination, take a thorough medical history, and, if required, advise tests:

• Complete blood count (CBC)
• Thyroid function tests
• Hormonal assessment (gonadotropins or sex hormones, prolactin and androgens)