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Gynaecology

A Gynaecologist is a physician who specializes in treating diseases of the female reproductive organs and providing well-woman health care that focuses primarily on the reproductive organs.

Apollo Cradle offers state-of-the-art care from a skilled team of Consultants who are experienced in treating gynecologic conditions. We provide a range of inpatient and outpatient services for women in all stages in life.

Prevention of illness is the focus at Apollo Cradles and we encourage women to have regular health checks to pick up health issues before they become a problem. Age specific health checks help you stay at optimum health.

Specialty Clinics provide you with an option to meet and consult with experienced Consultants for specific conditions.

Treatment options for gynecologic conditions range from minimally invasive procedures that can reduce the length of hospital stay, minimize pain and shorten recovery time to open surgery if required.

You can consult specialists who treat conditions of the pelvic floor such as bladder and bowel dysfunction and also have surgical treatment for cancer at the hospital.

Pelvic Inflammatory Disease

Pelvic inflammatory disease (PID) is an infection of the female reproductive organs, usually caused by a sexually transmitted infection. Although PID can often be treated quickly and effectively, if left untreated it can cause infertility.

PID can result if an infection spreads from your vagina and cervix (neck of your womb) to your womb (uterus), ovaries and fallopian tubes (the tubes that go from your ovaries to your womb).

PID can become a chronic (long-term) condition with acute flare-ups characterized by fever and abdominal pain. PID can affect the quality of life and maybe also your ability to have children.

Symptoms of PID
Most women with PID have no symptoms. If there are they may include fever, feeling sick or vomiting, a pain in the lower part of your abdomen, which may spread to your legs, uncomfortable or painful sex, pain when urinating, an abnormal vaginal discharge, irregular periods, or having heavier periods than usual.

Complications of PID
There are a number of possible complications of PID. These include infertility (seen in one in 10 women with PID). There are increased chances of having an ectopic pregnancy (pregnancy that occurs outside the womb, for example in one of the fallopian tubes). There may be complications with childbirth if you have had PID, such as having a pre-term baby or passing on the infection to your baby. Chronic pelvic pain can develop following PID.

Causes of PID
PID is most commonly caused by an STI (sexually transmitted disease) usually chlamydia or gonorrhoea, but it can be caused by other infections. Rarely, you can get PID without having an STI as bacteria that are usually found in the vagina and on the cervix can sometimes cause the condition.

You may develop PID in the first 2-3 weeks after having an intra-uterine device (IUD) inserted, after having an operation, such as a termination of a pregnancy or after giving birth.

Diagnosis of PID
It is very important to seek help early to reduce your chances of developing complications. Your gynaecologist may take specimens for testing from inside your vagina and cervix.  This is a simple procedure and can be done in the outpatient department. Symptoms of PID can mimic those of an ectopic pregnancy. He or she will also test a sample of your urine to check for a urinary tract infection. You may be advised further tests, such as a laparoscopy to examine the fallopian tubes, ovaries and womb.

Treatment of PID
If your doctor suspects that you have PID, he/she will prescribe antibiotics for you. You will also be given painkillers if you need them. It is advisable not to have sex until your treatment is completed.  

If other conditions like appendicitis or ectopic pregnancy have to be ruled out, you will need to be admitted in hospital. Your regular sexual partner will also need to have tests and treatment.

Menorrhagia

Menorrhagia is a condition when you have several regular heavy periods that affect you physically and emotionally. You may need to change your sanitary towel every two hours or more frequently or you need to use double sanitary protection (tampons and towels). You pass large blood clots. You bleed through and stain your clothes or bed linen or your periods affect your normal activities like going out, working or shopping.

Symptoms of menorrhagia
As well as heavy bleeding, you may experience longer periods than normal, tiredness, light-headedness or shortness of breath. These symptoms may not always be caused by menorrhagia but if you have them, you should consult your doctor.

Menorrhagia can cause anaemia that can contribute to some of these symptoms.

Causes of menorrhagia
Very often doctors aren't able to find a cause for menorrhagia. This is called dysfunctional uterine bleeding (unexplained menorrhagia).
However, menorrhagia can be caused by fibroids, polyps in your uterus, endometriosis, pelvic inflammatory disease, polycystic ovarian syndrome (PCOS), blood disorders, intrauterine contraceptive devices (IUCDs) and uterine cancer, although this is rare in younger women. It may also be seen in hypothyroidism.

Treatment of menorrhagia
Treatment will depend on whether a cause can be found for the menorrhagia. If no cause is found, treatment aims to reduce the heavy bleeding and prevent iron-deficiency anaemia from developing.

Medication may be prescribed. If unsuccessful, non-surgical treatments include uterine artery embolization or fibroid embolization to treat menorrhagia if you also have large fibroids that are causing bleeding. The arteries which supply your fibroids with blood are called uterine arteries. A uterine artery embolisation blocks off these uterine arteries, causing your fibroids to shrink.

Surgical options include endometrial ablation. This is a surgical treatment where most of your womb lining is destroyed or removed using energy such as microwaves or heat. It's not usually recommended if you have growths in your womb (fibroids) or if you want to have children in the future.
Hysterectomy will remove your uterus and is usually only done if other treatments haven't worked. After a hysterectomy, you will no longer have periods and won't be able to become pregnant.

Premenstrual syndrome (PMS)

PMS is a mixture of physical and emotional symptoms that some women have during the days, or sometimes weeks, leading up to their menstrual period. PMS is common in young and middle-aged women. It can start up to two weeks before your period and usually goes away when your period starts. PMS can affect the quality of your life and relationships.

Symptoms of PMS
Emotional and behavioral symptoms can include anxiety, mood swings, tiredness, irritability, depression and a loss in confidence. Physical symptoms can include headaches, feeling bloated, a change in your appetite, tender breasts and abdominal pain.

The timing of the symptoms is the sign of this condition. Symptoms appear during the two weeks leading up to your menstrual period, get better once your period has started and come back each month.

Diagnosis of PMS
There are no specific tests that can diagnose PMS. Your doctor will usually make a diagnosis based on a description of your symptoms and when they occur. Keep a diary of your symptoms for two menstrual cycles before you visit your doctor.  This will help you to see if the symptoms are related to your menstrual cycle.

It's important to distinguish between PMS and other problems that could be causing similar physical or emotional symptoms.

There are a number of treatments that can help relieve the symptoms of PMS.
If you keep a symptom diary, you can then predict more accurately how you will feel at certain times of the month. This may help you to plan your time so you can try to prevent being in stressful situations on key days and pinpoint any emotional triggers that make your symptoms worse.

Regular exercise and a healthy, balanced diet that is low in saturated fat, sugar and salt and high in fibre, vegetables and fruit will help. Reducing your intake of caffeine may also help.

Medicines:
If you have pain from premenstrual headaches, backache or other aches and pains, it may be relieved by painkillers.

If you have symptoms that are disrupting your life, and that don't improve with self-help measures or painkillers, see your doctor. He or she may prescribe medicines, depending on the type of symptoms you have. These may be hormone treatment, a diuretic, or antidepressant medication that may have a positive effect on the physical and behavioral symptoms of PMS.

Endometriosis

Endometriosis is a condition in which the tissue that normally lines the inside of the uterus the endometrium grows outside the uterus. It most commonly involves the ovaries, bowel or the lining of the pelvic region. It is rarely seen beyond the pelvic region.

Because it is influenced by hormonal changes in the same way that the lining of the uterus is influenced, it thickens, and bleeds with each menstrual cycle. This has no way to exit from the body so it remains, irritating the surrounding tissue, forming adhesions and scar tissue. When endometriosis involves the ovaries, cysts called endometriomas may form.

Endometriosis can cause pain especially during the days of your period. Fertility problems also may develop. Fortunately, effective treatments are available.
The symptoms that endometriosis commonly presents with are painful periods (dysmenorrhea), excessive bleeding during your periods, infertility, pain during intercourse, pain with passing urine or bowel movements as well as tiredness, diarrhea, constipation that is linked to your menstrual periods.

The symptoms mimic other conditions such as pelvic inflammatory disease (PID) or irritable bowel syndrome.

To diagnose endometriosis and other conditions that can cause pelvic pain, your doctor will take a detailed history. You will have a pelvic exam. It may not be possible to feel small areas of endometriosis, unless they've caused a cyst to form.
Your doctor will advise an ultrasound. Ultrasound imaging won't definitively tell your doctor whether you have endometriosis, but it can identify cysts associated with endometriosis.

Laparoscopy
Medical management is usually tried first. But to be certain you have endometriosis, your doctor may advise a Laparoscopy to look inside your abdomen for signs of endometriosis. He or she may take a biopsy. Laparoscopy can provide information about the location, extent and size of the endometrial implants to decide the best course of treatment.

Treatment for endometriosis is usually with medications or surgery.  Treatment depends upon the severity of your signs and symptoms and whether you hope to become pregnant.

Generally, surgery is treated as the last resort.

Pain medications such as the nonsteroidal anti-inflammatory drugs (NSAIDs) or naproxen may be prescribed to help ease painful menstrual cramps.

Getting regular exercise can help relieve symptoms.

Hormone therapy: Supplemental hormones are sometimes effective in reducing or eliminating the pain of endometriosis. It may recur after stopping the course of therapy.

Conservative surgery: If you have endometriosis and are trying to become pregnant, surgery to remove as much endometriosis as possible while preserving your uterus and ovaries may increase your chances of success. If you have severe pain from endometriosis, you may also benefit from surgery however, endometriosis and pain may return.

The procedure may be done laparoscopically or through open abdominal surgery in more extensive cases.

Assisted reproductive technologies such as in vitro fertilization, to help you become pregnant are sometimes suggested if conservative surgery is ineffective.

Hysterectomy: Hysterectomy is typically considered a last resort, especially for women still in their reproductive years. It is advised for severe cases of endometriosis. Hysterectomy with removal of both ovaries is performed, as the estrogen the ovaries produce, can stimulate any remaining endometriosis and cause the pain to persist.