Adolescent Clinic

Adolescence: a time of change.

Adolescence is one of the most important stages of human development. During the teenage years, young people face many physical, psychological, identity and relationship changes on their journey to adulthood. While adolescence is often stereotyped as a difficult and tumultuous time, it is important to remember that many adolescents move through this developmental stage of life respectfully and peacefully. Life Supports adolescent counselling services help teenagers and their families to identify ways to approach this time in a way that encourages their psychosocial development. Counselling helps teenagers to be safe, feel good about themselves, and engage in respectful relationships. At pranshu hospital you can get the best treatment by best obstetrician and gynecologist in indore.

What is PCOS ?

PCOS is a problem with hormones that affects women during their childbearing years (ages 15 to 44). Between 2.2 and 26.7 percent of women in this age group have PCOS.
Many women have PCOS but don’t know it. In one study, up to 70 percent of women with PCOS hadn’t been diagnosed.

PCOS affects a woman’s ovaries, the reproductive organs that produce estrogen and progesterone — hormones that regulate the menstrual cycle. The ovaries also produce a small amount of male hormones called androgens.

The ovaries release eggs to be fertilized by a man’s sperm. The release of an egg each month is called ovulation.
Follicle-stimulating hormone (FSH) and luteinizing hormone (LH) control ovulation. FSH stimulates the ovary to produce a follicle — a sac that contains an egg — and then LH triggers the ovary to release a mature egg.

PCOS is a “syndrome,” or group of symptoms that affects the ovaries and ovulation. Its three main features are:

  • cysts in the ovaries
  • high levels of male hormones
  • irregular or skipped periods
  • In PCOS, many small, fluid-filled sacs grow inside the ovaries. The word “polycystic” means “many cysts.”
    These sacs are actually follicles, each one containing an immature egg. The eggs never mature enough to trigger ovulation.
    The lack of ovulation alters levels of estrogen, progesterone, FSH, and LH. Estrogen and progesterone levels are lower than usual, while androgen levels are higher than usual.

    Extra male hormones disrupt the menstrual cycle, so women with PCOS get fewer periods than usual.

    Causes-

    Doctors don’t know exactly what causes PCOS. They believe that high levels of male hormones prevent the ovaries from producing hormones and making eggs normally. Genes, insulin resistance, and inflammation have all been linked to excess androgen production.

    Symptoms

    Some women start seeing symptoms around the time of their first period. Others only discover they have PCOS after they’ve gained a lot of weight or they’ve had trouble getting pregnant.

    The most common PCOS symptoms are:

  • Irregular periods.
  • Heavy bleeding.
  • Hair growth
  • Weight gain.
  • Male-pattern baldness.
  • Darkening of the skin.
  • Headaches
  • How PCOS affects your body

  • Infertility
  • Metabolic syndrome
  • Sleep apnea
  • Endometrial cancer
  • Depression
  • How PCOS is diagnosed

    Doctors typically diagnose PCOS in women who have at least two of these three symptoms (17):

  • high androgen levels
  • irregular menstrual cycles
  • cysts in the ovaries
  • What is Menstrual Problems ?

    Menorrhagia means heavy periods that recur each month. Also, that the blood loss interferes with your quality of life. For example, if it stops you doing normal activities such as going out, working or shopping. Menorrhagia can occur alone or in combination with other symptoms.

    Tests advices are:

    • An ultrasound scan of your uterus
    • Internal swabs
    • Endometrial sampling
    • A hysteroscopy
    • Blood tests

    Vaginal Discharge

    Vaginal discharge is any fluid or material that leaves a woman's body through the vagina. Some vaginal discharge is normal for all women, especially those in their reproductive years (ages 15 to 44). When the amount, quality or consistency of vaginal discharge changes, it may be a sign of disease or other irritation.
    Normal vaginal discharge is clear or white with no bad odor. It has regular fluctuations that result from hormonal changes occurring throughout the menstrual cycle. The normally clear and thin fluid becomes a bit thicker and heavier at the time of ovulation. Sexual excitement increases vaginal discharge. It also changes during pregnancy, at menopause and when a woman uses birth control pills.

    What is Urinary Problem ?

    The urinary tract is the part of the body that deals with storing and removing urine from the body. It is quite common for people to get infections in this part of their body.

    A urinary tract infection (UTI) occurs when an infection, usually caused by bacteria, enters the urinary tract.

    If that infection is in the bladder, it is known as cystitis. Cystitis can also be caused by irritation, even without an infection.
    The main symptom of a urinary tract infection, including cystitis, is the need to pass urine more often than usual. You may often feel an irritation as well.
    If those are the only symptoms you have, then you may be able to deal with the problem by yourself. But you should see a doctor if you have these symptoms and:

  • you feel unwell
  • you have a temperature
  • you have looked after yourself but it has not got better.
  • Looking after yourself

    If you have urinary problems, you can help ease the symptoms.

    Drink more water than usual, to help flush urine through, unless you have a medical condition which means this is not possible.

    If you are in pain, get advice on which pain relief medicines you can take. Talk to your pharmacist.

    You may be able to take medicines called urinary alkalinisers. These relieve the pain and burning of cystitis and are available from pharmacies without prescription. They are not antibiotics, but work by neutralising the acid in the urine that causes the pain. But they are not suitable for everyone, so check with a pharmacist first.

    Some people use cranberry juice to treat or prevent UTIs. There is not enough evidence from research to suggest it will work, but it might help relieve symptoms. But you should not drink cranberry juice or take cranberry extracts if you are taking warfarin (a medicine used to prevent blood clots).

    What is Cancer Screening ?

    Scientists continue to develop tests that help find specific types of cancer before signs or symptoms appear. This is called screening. The main goals of cancer screening are to:

    • Reduce the number of people who die from the disease, or eliminate deaths from cancer altogether
    • Reduce the number of people who develop the disease
    • Types of screening tests

      Each type of cancer has its own screening tests. Some types of cancer currently do not have an effective screening method. Developing new cancer screening tests is an area of active research.

      Breast cancer

    • Mammography.
    • Clinical breast examination.
    • Breast self-examination.
    • Magnetic resonance imaging (MRI).
    • Cervical cancer

    • Human papillomavirus (HPV) testing.
    • Pap test.
    • Colorectal cancer

    • Colonoscopy.
    • Sigmoidoscopy.
    • Fecal occult blood test (FOBT).
    • Double contrast barium enema.
    • Stool DNA tests.
    • Head and neck cancers

    • General health screening examination..
    • Lung cancer

    • Low-dose helical or spiral computed tomography (CT) scan.
    • Prostate cancer

    • Digital rectal examination (DRE).
    • Prostate-specific antigen (PSA) test.
    • Skin cancer

    • Complete skin examination.
    • Skin self-examination.
    • Dermoscopy.
    • Risks of screening

      Screening tests can help doctors find a cancer at an earlier, more treatable stage. This may help improve survival. However, cancer screening also has a number of risks. These risks include:

    • Overdiagnosis. Screening tests may find slow-growing cancers that would not have caused any harm during a person's lifetime. As a result, some people may receive potentially harmful, painful, stressful, and/or expensive treatments that they did not need.
    • False positives. Sometimes a screening test will suggest that a person has cancer when they do not.
    • Increased testing. Doctors may run additional tests that a person may not need because of overdiagnosis and false positives. These tests can be physically invasive, costly, and cause unnecessary stress and worry.
    • False reassurance. Sometimes a screening test will suggest a person does not have cancer when they actually do. As a result, a person may not get the treatment he or she needs.
    • Screening recommendations

      A number of organizations provide guidelines on cancer screening tests. Sometimes these guidelines suggest different things. Recommendations vary on:

      • Which type of cancer people should be screened for
      • Which tests should be used to screen for a particular type of cancer
      • What age screening should begin and end
      • How often screening tests should be done
      • What happens if the screening shows positive results?

    Cervical cancer

    Overview

    Cervical cancer is a type of cancer that occurs in the cells of the cervix — the lower part of the uterus that connects to the vagina.

    Various strains of the human papillomavirus (HPV), a sexually transmitted infection, play a role in causing most cervical cancer.

    When exposed to HPV, a woman's immune system typically prevents the virus from doing harm. In a small group of women, however, the virus survives for years, contributing to the process that causes some cells on the surface of the cervix to become cancer cells.

    You can reduce your risk of developing cervical cancer by having screening tests and receiving a vaccine that protects against HPV infection.

    Symptoms

    Early-stage cervical cancer generally produces no signs or symptoms.
    Signs and symptoms of more-advanced cervical cancer include:

  • Vaginal bleeding after intercourse, between periods or after menopause
  • Watery, bloody vaginal discharge that may be heavy and have a foul odor
  • Pelvic pain or pain during intercourse
  • Causes

    Cervical cancer begins when healthy cells acquire a genetic change (mutation) that causes them to turn into abnormal cells.

    Healthy cells grow and multiply at a set rate, eventually dying at a set time. Cancer cells grow and multiply out of control, and they don't die. The accumulating abnormal cells form a mass (tumor). Cancer cells invade nearby tissues and can break off from a tumor to spread (metastasize) elsewhere in the body.

    It isn't clear what causes cervical cancer, but it's certain that HPV plays a role. HPV is very common, and most women with the virus never develop cervical cancer. This means other factors — such as your environment or your lifestyle choices — also determine whether you'll develop cervical cancer.

    Types of cervical cancer

    The type of cervical cancer that you have helps determine your prognosis and treatment. The main types of cervical cancer are:

  • Squamous cell carcinoma. This type of cervical cancer begins in the thin, flat cells (squamous cells) lining the outer part of the cervix, which projects into the vagina. Most cervical cancers are squamous cell carcinomas.
  • Adenocarcinoma. This type of cervical cancer begins in the column-shaped glandular cells that line the cervical canal. Sometimes, both types of cells are involved in cervical cancer. Very rarely, cancer occurs in other cells in the cervix.
  • Risk factors

    Risk factors for cervical cancer include:

  • Many sexual partners.
  • Early sexual activity.
  • Other sexually transmitted infections (STIs).
  • A weak immune system.
  • Smoking.
  • Prevention

    To reduce your risk of cervical cancer:

  • Get vaccinated against HPV
  • Have routine Pap tests.
  • Practice safe sex.
  • Don't smoke.
  • Menopause

    Overview

    Menopause is the time that marks the end of your menstrual cycles. It's diagnosed after you've gone 12 months without a menstrual period. Menopause can happen in your 40s or 50s, but the average age is 51 in the United States.

    Menopause is a natural biological process. But the physical symptoms, such as hot flashes, and emotional symptoms of menopause may disrupt your sleep, lower your energy or affect emotional health. There are many effective treatments available, from lifestyle adjustments to hormone therapy.

    Symptoms

    In the months or years leading up to menopause (perimenopause), you might experience these signs and symptoms:

  • Irregular periods
  • Vaginal dryness
  • Hot flashes
  • Chills
  • Night sweats
  • Sleep problems
  • Mood changes
  • ?
  • Weight gain and slowed metabolism
  • Thinning hair and dry skin
  • Loss of breast fullness
  • When to see a doctor

    Keep up with regular visits with your doctor for preventive health care and any medical concerns. Continue getting these appointments during and after menopause. Preventive health care as you age may include recommended health screening tests, such as colonoscopy, mammography and triglyceride screening. Your doctor might recommend other tests and exams, too, including thyroid testing if suggested by your history, and breast and pelvic exams.

    Causes

    Menopause can result from:

  • Natural decline of reproductive hormones.
  • Hysterectomy
  • Chemotherapy and radiation therapy.
  • Primary ovarian insufficiency.
  • Complications

    After menopause, your risk of certain medical conditions increases. Examples include:

  • -Heart and blood vessel (cardiovascular) disease. Osteoporosis.
  • -Urinary incontinence.
  • -Sexual function.
  • -Weight gain.
  • What are ovarian cysts?

    Just because you’ve had an ovarian cyst or tumor doesn’t mean you have, or will develop, ovarian cancer. Many women get ovarian cysts or benign ovarian tumors at some point during their reproductive years. Most will never develop ovarian cancer.
    Your ovaries are small organs located deep within your pelvis. Eggs grow inside them, within a sac or follicle. During ovulation an egg is released from its sac into one of your fallopian tubes. After that, the sac typically dissolves, but sometimes the sac can remain and fill with air or fluid to develop into a cyst. Cysts that form in or around your ovaries often go unnoticed. They may cause only mild symptoms or no noticeable symptoms at all.
    It’s relatively rare, but some ovarian cysts are malignant, or cancerous. Fortunately, most are benign, or not cancerous. Your doctor’s recommended treatment plan will depend on the type of ovarian cyst or tumor that you have, as well as your symptoms. Oftentimes they won’t require any treatment.

    Types of ovarian cysts

    Sometimes, eggs mature in their sacs but are never released. As your menstrual cycle repeats, the sacs may grow larger and develop into multiple cysts. This condition is known as polycystic ovary syndrome (PCOS).

    There are other types of ovarian cysts and tumors too. For example:

  • Ovarian endometriomas can develop if you have endometriosis, a condition that causes the endometrial tissue lining your uterus to grow in other areas of your body. If this tissue attaches to one of your ovaries, an ovarian endometrioma can form.
  • Ovarian cystadenomas are liquid-filled cysts that develop from cells on the surface of your ovary. While most are benign, some cystadenomas are cancerous.
  • Ovarian dermoid cysts, or teratomas, are made up of a variety of different cell types. They’re a type of ovarian germ cell tumor. Usually these tumors are benign, but occasionally they can be malignant.
  • What are ovarian cysts?

    The ovaries are part of the female reproductive system. They’re located in the lower abdomen on both sides of the uterus. Women have two ovaries that produce eggs as well as the hormones estrogen and progesterone.

    Sometimes, a fluid-filled sac called a cyst will develop on one of the ovaries. Many women will develop at least one cyst during their lifetime. In most cases, cysts are painless and cause no symptoms.

    Types of ovarian cysts

    There are various types of ovarian cysts, such as dermoid cysts and endometrioma cysts. However, functional cysts are the most common type. The two types of functional cysts include follicle and corpus luteum cysts.

    Symptoms of an ovarian cyst

    Often times, ovarian cysts do not cause any symptoms. However, symptoms can appear as the cyst grows. Symptoms may include:

  • abdominal bloating or swelling
  • painful bowel movements
  • pelvic pain before or during the menstrual cycle
  • painful intercourse
  • pain in the lower back or thighs
  • breast tenderness
  • nausea and vomiting
  • Severe symptoms of an ovarian cyst that require immediate medical attention include:

  • severe or sharp pelvic pain
  • fever
  • faintness or dizziness
  • rapid breathing
  • What is Pelvic Floor Repair Surgery ?

    If your pelvic floor disease symptoms do not respond to conservative treatment your consultant may recommend surgery for pelvic floor repair.

    The muscles, ligaments and connective tissue that hold a women’s internal organs in place are called the pelvic floor. The bladder, bowel, uterus, vagina and rectum are held in place by the pelvic floor. Your brain controls your pelvic floor muscles to help these organs function correctly. Several medical conditions, an injury or childbirth can cause a weakness or tears in the pelvic floor muscles called pelvic floor disease.

    What happens during pelvic floor repair?

    There are several types of pelvic floor repair. Your surgeon may perform several procedures during your operation. You should have a detailed discussion with your consultant to determine which option is the best in your case.

    Anterior repair - repairs the weak muscles in the front wall of the vagina that support the bladder (anterior prolapse). An anterior repair is usually performed under general anaesthetic. The operation usually takes about half an hour.

    Your surgeon will make a cut in the anterior (front) wall of your vagina so they can push your bladder and urethra back into place. They will stitch the support tissues together to provide better support for your bladder and urethra. They may cut away a small part of the vaginal wall to remove tissue left over from the repair.

    Posterior repair - repairs the muscles in the back wall of your vagina that support your bowel (posterior prolapse). A posterior repair is usually performed under a general anaesthetic. The operation usually takes about half an hour.

    Your consultant will make a cut in the back (posterior) wall of your vagina so they can push your bowel back into place.They will use stitches to tighten the supporting tissues along the length of the back wall of your vagina. They may need to cut away a small part of the vaginal wall to remove excess tissue. If the muscles on either side of your entrance to your vagina are weak they may use stitches to tighten them as well.

    You should expect a slight discharge or bleeding from your vagina but you should let a member of the healthcare team know if this becomes heavy.