Optics of OB-GYN

Optics of OB-GYN

Among the most typical gynaecological problems that women experience, there are some significant symptoms that doctors see as warning signs

Menstrual cycles, pregnancy, birth control, and menopause are just a few of the specific health issues that affect women, but most of these are disregarded as a normal progression to ageing. There is a potential that some health conditions will get complicated or misdiagnosed as benign when they are actually very significant and shouldn’t be disregarded.

Menstrual cycle

A regular and natural change in the female reproductive system called a menstrual cycle makes conception possible. Many primordial oocytes in the ovaries mature into a single oocyte that is prepared for fertilisation throughout a typical monthly cycle. However, an unusual uterine haemorrhage can occur due to some physiological disturbances that include:

Dysmenorrhea: Dysmenorrhea, a painful menstruation that can occasionally affect women, goes away as the menstrual cycle starts. Many women choose to ignore their pain because they think that taking medications will reduce their fertility index. Periodic pelvic congestion can occasionally be the source of pain, as can pelvic pathology like an ovarian cyst, fibroid uterus, endometriotic cyst, or pelvic inflammatory disease.

Post-coital bleeding: Post-coital haemorrhage, which is intermittent, irregular vaginal bleeding, or post-coital bleeding may be a presenting complaint in cases of erosion, cervical polyps, or cervical cancer. Premenstrual syndrome, often known as premenstrual stress, is one of the frequent health conditions affecting women. That happens to one in three women just before their period. Irritability, mood fluctuations, lack of confidence, anxiety, restlessness, etc., are some of the most common symptoms.

PCOS with hirsutism: The most common reasons for PCOS include high levels of androgen in the body, genetics, or an excess of insulin in the body. Women who have PCOS may experience irregular or low menstrual cycles, high testosterone levels, and polycystic ovaries. It is advisable for single girls to keep up their exercise, diet, and weight management regimens. Antiandrogens can be administered in addition to aesthetic hair removal. White discharge from the vagina — abnormal excess discharge or an odd odour, and whether or not there is accompanying irritation. Stay away from excessive sweets and perineal hygiene. Always rule out cervicitis, fungal infections, and STDs like chlamydia.

Vulvodynia: Vulvodynia entails the disorders of the vulva which include pain, itching, swelling or tender vulva. Dysperunia is pain during intimacy, and some may have vaginismus which is the involuntary tensing of the vagina that interferes with sexual intercourse. It often makes any vaginal penetration difficult or impossible due to pain or fear of pain.

Urinary incontinence: Incontinence, in particular stress incontinence, can actually lower quality of life. Women are often reluctant to talk about this but stress urinary incontinence (SUI) indicates uncontrollable urination after effort, physical activity, or when sneezing or coughing.
♦ It is the kind of urine incontinence (UI) that affects pregnant women the most frequently.
♦ It is known to have negative effects on quality of life (QoL) in four areas: physical activity, travel, social interactions, and emotional health in 54.3% of all pregnant women.

Premarital counselling: The couple’s premarital health is not given much consideration, especially if they have any inherited or pre-existing genetic conditions. Sometimes, families choose not to prepare women. Or in some cases,  consanguineous marriages exist, which can result in the transmission of diseases like thalassemia, haemophilia, or chromosome abnormalities.

Honeymoon cystitis: Soon after marriage, some women report an abrupt beginning of pain, burning while urinating, or an increase in frequency. Many women suffer from UTI symptoms that get triggered by a shift in the vaginal flora. Sexual activity aids in spreading the infection.

Vaginal itching or excess discharge: Women typically produce watery, sticky discharge around the time of ovulation, and slightly thicker, white discharge as menstruation approaches. But, if there is an itching or odour with excessive discharge, you should see a doctor.

Vulval warts: Warts are brought on by low-grade human papillomavirus subtypes. It requires attention when it’s simply growing. If these women’s antibody to infection is inadequate, they have a significant risk of developing cervical cancer later in life. One of the common health issues affecting women is premenstrual syndrome, sometimes referred to as premenstrual stress. One in three women experiences it prior to their period. Some of the most prevalent symptoms include irritability, mood swings, loss of confidence, anxiety, restlessness, etc. 

Mastalgia, also known as breast pain, is a common disease that can be either diffused or localised, unilateral or bilateral. Typically, an infection or a specific illness that results in a tumour, like a breast cyst, causes localised breast discomfort (eg, mastitis, abscess). A large percentage of breast cancers cause no discomfort. Diffuse bilateral pain may be brought on by fibrocystic changes or, less commonly, diffuse bilateral mastitis.

Yet diffuse bilateral discomfort is common in women without breast issues. The most common causes in these women are hormonal changes that encourage breast tissue proliferation, like those that take place during the luteal phase or in the first trimester of pregnancy in women taking estrogen or progestin.

Breast abnormalities like masses, nipple inversion, or discharge are sought after during the inspection of the breast, which is the main emphasis.

Skin changes like erythema, rash, eczematous appearance, oedema, or dimpling (also called peau d’orange or orange peel) should also be watched out for, as should infection signs like redness, warmth, and sensitivity. For menstrual-related mastalgia, acetaminophen or a nonsteroidal anti-inflammatory drug (NSAID) are frequently helpful.

If the discomfort is unbearable, a brief dose of danazol or tamoxifen may be given. These drugs inhibit testosterone and progesterone. It might be necessary to stop using estradiol or progestin.

(The author is a consultant in obstetrics & gynaecology.)

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