Women's health is a vital aspect of overall well-being, encompassing physical, mental, and emotional health influenced by unique biological and hormonal factors. Key areas include reproductive health, menstrual care, pregnancy, menopause, and conditions like PCOS and endometriosis. Women are also more prone to osteoporosis, certain cancers, and cardiovascular issues, highlighting the importance of preventive care, nutrition, and regular check-ups. Mental health, including managing stress, anxiety, and postpartum challenges, plays a crucial role. Empowering women with education and access to healthcare enables them to lead healthier, more fulfilling lives.
Gynaecology is a medical specialty focused on the health of the female reproductive system, including the uterus, ovaries, fallopian tubes, and vagina. It involves diagnosing, treating, and managing conditions such as menstrual disorders, infertility, pelvic pain, infections, and reproductive organ diseases. Gynaecologists also provide preventive care, including Pap smears, contraceptive advice, and menopause management. This field is essential for ensuring women's reproductive and overall health throughout different life stages.
Period problems
Many women experience mild pain and discomfort during their periods, however if pain is more than usual it could be due to some underlying cause. Having a check with our doctor will help in improving menstrual quality of life.
Premenstrual dysphoric disorder (PMDD)
In PMDD women may experience premenstrual symptoms (PMS) such as bloating, headaches, breast tenderness weeks before their period is due. PMDD also causes severe anxiety, depression and mood swings. Some women may even become suicidal. Symptoms improve within days after periods start. It is more severe than PMS and can significantly impact the quality of life. Our doctor will discuss treatment options to relieve these symptoms.
Hormonal imbalance
Hormonal imbalance may cause symptoms from fatigue to weight gain to skin/hair issues. Hormones are produced by glands and released into bloodstream. An imbalance occurs when there is too much or too little of a hormone. Hormones are very important for regulating body temperature, mood, appetite, metabolism, sleep cycle, reproductive cycle and sexual function. A slight change in hormone can effect overall heath and wellbeing. Mood swings, heavy or no periods, poor quality sleep, unexplained weight gain, loss of libido, infertility and skin problems can all be manifestations of underlying hormone imbalance.
Skin issue like adult onset acne can be due to low estrogen and progesterone and high androgens and can indicate polycystic ovary syndorme (PCOS).Similarly hormone imbalance during pregnancy and meopause can cause several skin issues.
PCOS
PCOS can affect your periods, Fer hormones. It can also affect long term health if not addressed on time. Symptoms usually include irregular periods or no periods at all, infertility, weight gain or difficulty in losing weight. Hormonal imbalance may also cause oily skin, acne, loss of hair on head, excessive hair growth over face and/or body. Some may experience depression or psychological problems. Symptoms vary from person to person with some being asymptomatic and others have mild to severe symptoms. Cause of PCOS is unknown, it can run in families. Symptoms are related to hormones insulin and testosterone. Insulin controls blood sugar. In PCOS body may not respond to insulin effectively and result in high glucose levels. This is termed Insulin Resistance. Body reacts to this high glucose level by producing more insulin. This high level of insulin can cause weight gain, irregular periods, infertility, acanthosis nigricans, and high levels of testosterone. Testosterone is produced by all women in small amounts but in PCOS levels may be much higher causing many symptoms such as oily skin, acne, loss of hair on head, excessive hair growth over face and/or body. PCOS can be difficult to diagnose. Our doctor will examine you, get some blood tests done and also an ultrasound to confirm the diagnosis of PCOS. If left untreated it will predispose women to risk of insulin resistance and diabetes (up to 20% of women with PCOS can develop diabetes), high blood pressure, womb cancer, depression and mood swings.
While there is no cure for PCOS, we at BMWC, work as a team to reduce the long-term health impact of PCOS by using a comprehensive approach, which can involve use of medications and life style changes to manage optimal weight by following healthy balanced diet with low glycemic index, reduced sugar, salt, caffeine and regular exercises.
Birth control
Birth control is any medicine, device or method used to prevent pregnancy and can include pills, intrauterine device (IUD), vasectomy and condoms. If you are sexually active and don't want a baby, use birth control. A pregnancy can happen anytime you have unprotected sex. Birth control only works if used correctly. Birth control only works if used correctly and consistently. You and your partner can make decision after discussing with our doctor. A birth control should be easy to use, effective against preventing pregnancy and STIs Your doctor at BW, will you give you options based on your age, overall health condition and plans for pregnancy. The most effective form of birth control is to not have sexual intercourse (abstinence). This might be difficult so it is important to have a backup plan. Doubling up birth control is typically the best like using a condom and a birth control pill. This protects against STIs using a barrier (condom) and being on hormonal pill at the same time. Some birth controls are more convenient and don't need much maintenance such as birth control implant, IUDs and sterilization. Hormonal medications are short acting so require daily use, implants are inserted into arm or uterus and are long acting. Sterilization is surgery to prevent pregnancy. There are male and female sterilization methods (removing fallopian tubes, tubal ligation and vasectomy). Fertility awareness (calendar method, cervical mucus method, basal body temperature) is natural family planning but is least effective. Emergency contraception provides protection if your birth control method fails. This is the last safety net in preventing pregnancy. It is effective if used within 5 days preferably within 3 days. You can immediately get in touch with your doctor at BW if you are concerned about failure of birth control to discuss the best emergency contraception option for you.
Premature ovarian failure (POI)
In POI or premature menopause or premature Avarian failure, ovaries stop producing hormones (estrogen, progesterone and testosterone) before age 40. This can have a huge impact on quality of life. Our team will treat POI and guide you efficiently and ensure your long-term wellbeing.
Menopause
Menopause marks the end of the menstrual cycle. It can happen in 40s or 50s but averages age is 51, diagnosed when you have gone without a menstrual cycle for 12 months. Estrogen and progesterone production drops and a big drop in estrogen causes most of the menopausal symptoms. It is a natural event and a significant phase which all women go through. It can be accompanied by disturbing changes in the body varying from person to person. The hormonal shift can cause physical and emotional changes including hot flushes, night sweats, mood swings. Sleep disturbance, weight gain and vaignal dryness. Our knowledgeable team of experts at BMWC, are committed to helping you understand the changes within your body and offering you personalized guidance to ensure your overall well being.
Perimenopause is the time just before the menopause. Often the first sign is irregularity of cycles and mood swings. Then follows the menopause which marked by no menstrual period for one year. The years following the menopause is the post menopause stage. Many previous symptoms will improve but women need to be aware of bone (osteoporosis) and heart health.
Menopause symptoms can have significant effect on a women's life both at work and home. There are many lifestyle, complementary, medical and alternative options available at BM.
Hot flushes/night sweats most commonly reported by women and may last for couple of years. Hot flush last for 3-5 minutes, can cause sleep disturbance and insomnia. Management includes lifestyle changes, alternative treatments, hormone replacement therapy (HRT) and other medications.
Reducing consumption of alcohol and caffeine, maintaining optimal weight, avoiding spicy food, wearing loose cotton clothing and keeping the room temperature low are some helpful tips to reduce discomfort of hot flushes. If these tips are not very helpful medical and alternative treatments will be discussed by our team.
Changing levels of estrogens also affect other hormones like the ones which regulate mood and emotions. Irritability, anxiety, forgetfulness and others may be related to hormonal imbalance or also due to sleep disturbance caused by night sweats. Your lifestyle may also be contributing to these symptoms like stress.
Low levels of estrogen and testosterone cause vaginal dryness resulting in sexual discomfort. Vaginal moisturizers and lubricants will rehydrate vaginal skin and reduce the discomfort. Local hormone therapy will improve vaginal skin by thickening the walls, improving the elasticity and lubrication.
Some may also notice other symptoms such as increase in urination, urine infections, leakage of urine and others. These symptoms can be distressing and further contribute to stress if not addressed on time. The impact of menopause is unique to each woman. Our team of experts will create a personalized plan based on your symptoms, general health and lifestyle for you to cope with this transition period and also order some tests to make sure you stay heathy.
Vaginal atrophy/atrophic vaginitis/ vaginal dryness/vulvovaginal atrophy and genitiurinary syndrome of menopause (GSM) are terms used for thinning of vaginal tissue, reduction of elastic tissue and also reduction of vaginal fluids due to estrogen deficiency.
Vaginal tissue is very delicate. Glands near the cervix produce a lubricating fluid to keep vagina moist. This fluid also helps in keeping vagina clean and removing dead cells, it is acidic and prevents infections such as thrush. In post-menopausal women vaginal dryness is common up to 60% may suffer. Also, women with breast cancer, breast feeding mothers, women who had hysterectomy or chemotherapy may experience vaginal dryness. Use of chemicals in hygiene products and washing powders may also cause dryness.
Vaginal dryness can cause many uncomfortable symptoms like burning, painful sex, change in vaginal discharge, genital itching, burning with urination, frequent urinary tract infections and urinary incontinence.
Treatment involves life style changes. Use of vaginal lubricants and moisturizers. Pelvic floor exercises. Avoid perfumed soaps. You can discuss hormone treatment topical or systemic with our doctor. Laser treatments are being studied and preliminary results are encouraging.
Osteoporosis
Menopausal women are at risk of bone thinning disease osteoporosis due to low levels of estrogen hormone. It is a painful and debilating disease. Bones become fragile and break easily. It can occur in any part of the body commonly affecting wrist, hips and spine. Spinal fracture can cause loss of height and curvature of the spine. From 40s onwards our bones gradually lose density but following menopause this tends to be faster. Women who had early menopause, family history of osteoporosis, smokers, previous impact fracture or on steroid therapy are particularly at more risk.
As osteoporosis causes no symptoms, usually it is not until a bone is broken diagnosed. EXA scan measures bone density. Osteopenia is bone density lower than average normal but not low enough to be called osteoporosis. The lower the bone density, higher the risk of bone fracture. With Dexa scan it is now possible to detect osteoporosis before a bone is broken. It is also useful to monitor the response to treatment. It is quick and simple procedure. Our experts will discuss the result of your scan and also determine your calcium and vitamin D which are essential for maintaining bone health.
Osteoporosis once diagnosed is treated with specific medications like bisphosphonates, selective estrogen receptor modulators (SERMs) and HRT if you have other acute symptoms of menopause.
Hormone replacement therapy (HRT)
For some with severe symptoms hormone replacement therapy (HRT) may be needed. Benefits and risks of HRT will be discussed. For most women benefits outweigh the risks associated with HR. Apart from helping with night sweats, hot flushes, mood swings and bladder symptoms has significant effect on bone health, increasing the bone density. Before prescribing HRT, our team will take a detailed account of your personal and family health history. There are no scientific data that’s shows an increased risk of cervicovaginal and vulval cancer with HRT. Continuous combined HRT appears to reduce the risk of endometrial cancer. The risk of breast cancer does not appear to increase within the first 5 years of HRT use, and if present is no greater than 1 extra case per 1000 women per year. Risk of Avarian cancer remains controversial but if present is no more than 1 extra case per 500 women per year. HRT may be associated with an increased risk of developing clot. Transdermal HRT avoid stimulating clotting factors.
When HRT is used, a combined treatment is often recommended consisting of estrogen and progesterone. In women with uterus, this progesterone protects the uterine line from excessive stimulation by estrogen. Progesterone can be cyclical or continuous (no bleed HRT). Testosterone can be added to improve libido. There are various types and delivery methods which will be discussed by our doctor.
Estrogen can cause bloating, breast tenderness, nausea, headache. Progesterone can cause fluid retention, weight gain, fatigue, breast discomfort and others. Progesterone seems to be the most common cause of side effects and using it as vaginal pessary instead of taking orally, can reduce side effects significantly.
HRT is for women below the age of 60 years. It is also used for women with premature ovarian failure or early menopause.
Some contraindications are undiagnosed abnormal vaginal bleeding, active or recent blood clot or heart attack, suspected or active breast or endometrial cancer and active liver disease with abnormal liver function test.
HRT helps to restore hormonal balance and alleviates the symptoms and promotes over all wellbeing in women who are having difficulty in coping with these distressing symptoms.
Fibroids
Fibroids are very common affecting around one in three women aged 30 to 50 years. They may be asymptomatic and diagnosed during a routine scan. In many they don't cause major concern and shrinks with onset on menopause. In some women they can cause excessive menstrual bleeding impacting quality of life and fertility. Our doctor will perform some diagnostic tests and discuss the treatment options best for you.
Endometriosis
Endometriosis is a condition where tissue similar to lining of uterus develop in other places like bowel, bladder and ovaries. This can cause scarring and adhesions. It can be associated with heavy, painful periods and pain during sex. It may cause difficult in becoming pregnant. It cannot be cured but can be managed.
Ovarian cyst
These are fluid filled sacs that can grow on ovaries. Most disappear and are harmless. In some they can cause pain, bloating or irregular periods. Our doctor will perform a scan and some tumor markers to ensure they are benign.
vulval Skin Diseases
Area around the vagina is vulval area. It includes labia (inner and outer labial lips) and clitoris. Many women may experience itching, pain, soreness and change in skin color of vulva. Following conditions may affect vulval skin:
- a) Folliculitis appears as small, red bumps. This can happen because of shaving, waxing or even friction.
- b) Dermatitis especially contacts dermatitis caused by irritation of the skin by use of perfumed soaps and other skin care products.
- c) Bartholin gland cyst Bartholin glands are present on either side of vaginal opening. They release fluid that helps in lubrication during sexual activity. If the gland is blocked, a cyst may form causing a swollen bump near vaginal opening. It can form an abscess Abd become painful.
- d) Lichen simplex chronic us (LSC) LSC is thickened skin which can occur due to long standing skin conditions such as chronic dermatitis may cause intense itch and cause disturbed sleep.
- e) Lichen sclerosis (LS) LS causes itching, burning, pain during sex and tears in skin. Skin may appear thin, crinkled with white bumps.
- f) Lichen Planus LP
- g) Vulvodynia Vulvodynia may cause pain, burning, stinging, irritation and rawness in vulva. Some describe it as soreness, throbbing pain. Pain may be in entire area or just in clitoris or vestibule. Symptoms may come and go. Inserting tampon, having sex, tight underwear can trigger pain in some women.
- h)Vulvar intraepithelial neoplasia (VIN) VIN is the presence of abnormal vulvar cells that are not yet cancerous. It is often caused by HPV infection
Vulvar intraepithelial neoplasia (VIN)
VIN is the presence of abnormal vulvar cells that are not yet cancerous. It is often caused by HPV infection
Vulval cancer
Cancer is growth of abnormal cells. Vulval cancer can be caused by HPV infection. Melanoma (skin cancer) and other forms of cancer may involve vulval area such as pagets disease. It may present as pain, inflammation, lump or sore on the vulva and change in skin color.
STIs can also affect vulva such as genital herpes.
Breast Health
Breast Cancer
An important aspect of women wellness is breast health. It begins with breast awareness. Breast changes happen during different times such as during menstrual cycle, pregnancy and menopause. Being familiar how your breast feels helps in detecting any change such as a lump, pain or nipple discharge. Between age 29-39, women should have a clinical breast examination every 1 to 3 years. After age 40 women should have a breast exam by healthcare provider every year. Having a family history of breast cancer or high-risk breast lesions requires to undergo routine screening tests like clinical examination, mammogram, ultrasound and sometimes a breast MRI.
Others Cancers
Uterine Cancer
Uterus is an organ in women’s pelvis where an unborn baby develops. The lining of the uterus is called endometrium. Endometrial cancer/uterine cancer is the common type of cancer and is often treatable. Family history of endometrial cancer, obesity and metabolic disorders, taking tamoxifen for breast cancer or estrogen alone can increase the risk of endometrial cancer. Vaginal bleeding after menopause, or vaginal bleeding not related to menstrual period, pain in the pelvic area is some of the symptoms of uterine cancer. Diagnosis is confirmed by physical examination, ultrasound and a biopsy.
Cervical Cancer
The primary risk factor of cervical cancer is the HPV infection.Cervical cancers can be prevented by routine screening and by treating exsisting precancerous conditions.Some of the cervical cancer screening tests are Pap smear and HPV testing, Women who have undergone hysterectomy with removal of cervix for a benign disease rarely have abnormal Pap smear test.
Ovarian Cancer
Ovarian cancer is abnormal growth of cells in the ovaries. Early symptoms may be bloating,diarrhea and abdominal pain.Exact cause of ovarian cancer is not known.Middle aged or older women with family history of ovarian cancer are more at risk.Blood test CA125 is tumor marker for ovarian cancer. Imaging tests like ultrasound are used to diagnose ovarian cancers.
Vulval Cancer
Cancer is growth of abnormal cells. Vulval cancer can be caused by HPV infection. Melanoma (skin cancer) and other forms of cancer may involve vulval area such as pages disease. It may present as pain, inflammation, lump or sore on the vulva and change in skin color.
Colon Cancer
It is the cancer of the colon. They usually start as a growth on the inner lining of the colon. These growths are called polyps. Most of these polyps are noncancerous. Some may change turning into cancer. Following a healthy lifestyle and routine screening tests help to reduce deaths due to this cancer.
Lung Cancer
Lungs are two spongy organs in the chest. People who smoke have the greatest risk of lung cancer. Risk increases with the number of cigarettes smoked and the duration of smoking. Quitting smoking significantly reduces the chances of developing lung cancer. Exposure to second hand smoke also increases your risk of lung cancer. Other risk factors such as family history of lung cancer, previous radiation therapy, exposure to radon gas and others also puts you at more risk of developing lung cancer.
Cancer Screening
Checking for cancer (or for pre cancer lesions that may become cancer) in people with no symptoms is called screening. Detecting cancer early significantly reduces the chances of dying from it. Cancer screening is an important part of wellness. Some of the recommended screening tests are for breast cancer, cervical cancer, lung cancer, colon cancer and prostate cancer. These include clinical examination, series of blood and imaging tests. Make sure you know the frequency and timing of screening for various cancer.
Talk to our health experts to help you understand the importance of cancer screening. You will find affordable packages and programmed at "Banka Wellness" which is dedicated to create awareness of health issues and create a healthy society comprising of children, adolescents, young and senior adults.
Reproductive Medicine & Infertility
Infertility is a failure to achieve pregnancy after 12 months or more of regular unprotected sexual intercourse. It affects millions of people and has significant impact on quality of life. Approximately one in six people of reproductive age experience infertility in their lifetime. In men the common causes of infertility are problem in ejection of semen (tubule disorders like blocked tubes due to infection or injury),low sperm count ( due to varicocele,chemoptherpay)or abnormal sperm shape or sperm movement( for example due to use of anabolic steroids).In females it could be due to abnormalities of ovaries ( such as PCOS),utertus (such as endometriosis, fibroids) , fallopian tubes(blocked tubes due to STIs , previous abdominal or pelvic surgery),or due to hormonal imbalance (hypopituitarism) and others. Primary infertility is pregnancy has never been achieved and secondary infertility is at least one prior pregnancy has been achieved.
Infertility care includes prevention, diagnosis and treatment. Unfortunately, in many countries fertility care is not a priority. It remains a challenge especially for low- and middle-class income group. Addressing infertility is important as it is the right of an individual and a couple to start or expand a family. Although infertility can be experienced by both men and women, it is often women who are perceived to suffer from infertility, regardless of whether they are infertile or not. It has a significant negative social impact on the lives of infertile couple particularly women who often face divorce, violence, emotional stress, social stigma, anxiety, depression and low self-esteem.
Addressing infertility has some major barriers like lack of trained staff, high cost of treatment, necessary equipment. While assisted reproduction technologies like in vivo fertilization (IVF) are now available for more than three decades, these are still inaccessible and unaffordable in many parts of world. We at BW focus on community health and over all wellbeing. Our team of infertility specialists will help you as a couple in diagnosis and treatment of infertility by performing some blood tests and scans. We try our best to make this process affordable. In most cases, people with infertility have high chances of achieving pregnancy with medications, surgery or IVF. Your chances of getting pregnant decrease with age. Don’t delay conception until an advanced age. Lifestyle modification and stress management will also be discussed in details at our facility. Infertility has emotional, physical, financial and psychological impact. Being patient with yourself and your partner throughout the process in important to achieve your goal of pregnancy.
Digestive Health
IBS is a group of symptoms that occur together such as abdominal pain, bloating gas, cramps, diarrhea or constipation or both. These symptoms occur without any visible signs of damage or disease of digestive system. It is a common chronic disorder that needs long term management. Most people can control symptoms by managing diet, stress and stress. If you have persistent change in your bowel habits or other symptoms of IBS, see our doctor to rule out more serious conditions such as colon cancer. Follow diet advise under lifestyle