February 26. 2022

Michelle Obama, the former first lady of the United States of America once famously said “Communities and countries and ultimately the world are only as strong as the health of their women”.

Sadly though, the only times most women in India visit the doctor for health-related issues are during pregnancy or when things have gotten out of hand. Indian women are hesitant to talk about gynaecological symptoms and suffer in silence due to considerable taboo attached to the word ‘menses’ or due to the embarrassment associated with an internal examination. Just as how most of us make it a point to visit a physician for an annual health check-up, a yearly gynaecological examination will help detect numerous diseases, which if left unattended to, could lead to serious health issues in the future.

Here's a brief insight into the common gynaecological problems many women face in their day to day lives.

1. Polycystic Ovarian Syndrome

One in 10 women in India suffer from Polycystic Ovarian Syndrome, of which 6 are teenagers. PCOS has in the recent past emerged as a prominent healthcare issue among our young adults. The cause although unknown, hormonal imbalances owing to either excessive weight loss or weight gain or lifestyle and dietary choices are known to be implicated.

Women with PCOS present with irregular periods or symptoms due to excessive male hormone(androgen) levels such as acne/pimples, darkening of skin around neck and armpits, hair loss, weight changes. Some may have difficulty in trying to get pregnant.

The ovaries fail to function normally and are enlarged and filled with fluid and therefore unable to release the eggs cyclically.

In the long run, these women are prone to develop metabolic syndrome, diabetes, heart disease and psychological disorders. Exercise and lifestyle modifications go a long way in controlling PCOS while many require evaluation and medications depending on their symptoms.

2. Fibroids

These are non-cancerous tumours of the uterus. As many as 1 out of 5 women have fibroids during their child bearing age and almost half of all these women by the age of 50. These may be single or multiple and can be of varying sizes. Symptomatology ranges from heavy menstrual bleeding, dysmenorrhea, enlarged abdomen, infertility, pain abdomen, urinary problems, recurrent pregnancy loss, pregnancy related problems while 50% remain asymptomatic.

Fibroids can easily be detected during a gynaecological examination and confirmed on ultrasound. Treatment plan varies depending on the age of the patient, severity of symptoms, size and location of the fibroids and the wishes of the patient.

3. Endometriosis/Adenomyosis

This is a condition where the lining of the uterus gets deposited and grows in sites other than the uterus. Commonly, on ovaries forming chocolate cysts and over pelvic organs resulting in inflammation/ scarring thus making the organs adherent to one another. This affects approximately 6-10% of women in the reproductive age group. Symptoms include severe pain during menses which is not relieved on painkillers or heavy and prolonged menstrual bleeding.

As much as 30 to 40% have difficulty in getting pregnant. Management depends on the age of the patient, severity of symptoms and whether the lady wants to plan pregnancy or not and includes oral medications, injections and even surgery.

4. Vaginal Infections

Extremely common but ignored most often. Leucorrhoea means normal vaginal discharge which increases mid cycle and prior to menses and is non foul smelling, with no itching. Discharge which is green/ yellow/brown or mixed with blood, foul smelling, copious or associated with itching needs medical attention. Examination, culture and appropriate treatment can prevent complications like pelvic inflammatory disease, recurrent pregnancy loss, chronic pelvic pain and infertility.

Prevention:
Keep private parts clean and dry wash with lukewarm water.
Avoid using douches and perfumes.
Clean the private parts every time you visit the washroom by wiping from front to back and not vice versa.
Wear fresh dry cotton undergarments.
Use condoms during intercourse to prevent sexually transmitted infections.
Drink plenty of water, maintain a healthy diet and exercise.
Undergo annual gynaecological examination with pap testing once every 3 years.

Women are very good at putting others’ needs ahead of their own, however it is imperative that they take care of themselves which in turn will go a long way in them caring for others. So, on Women’s Day this year (2022), let us women be extra vigilant on our physical and mental health. Because, if you’re scurrying to and from appointments and errands, you don’t have a lot of time to take care of yourselves.

Let’s vow to do a better job of putting ourselves higher on our own ‘to do’ list.

Taking care of yourself doesn’t mean me first, it means me too.

Happy Women’s Day!