Dr. Lalita Badhwar, MBBS, M.D, is a Senior Consultant Gynaecologist and Advanced Hysteroscopic & Laparoscopic Surgeon at the Indraprastha Apollo Hospital, New Delhi. A Gold Medallist from Maulana Azad Medical College, a premier Medical college of India, she has super specialized in the field of Gynec Laparoscopic surgery for which she received training in Germany.
Dr Badhwar has over Thirty years of experience in Gynaecology. She has a special interest in the treatment of infertility, endometriosis, fibroids, ovarian cysts, menopausal medicine and gynaecological hormonal disorders e.g, PCOD.
She talks about menstrual health and common issues faced by women. On the International Women’s Day, Dr. Lalita while calling for equality and equal opportunities for men and women, she emphasizes that being bedrock and backbone of the family women need to take care of their health. She also talked about various health issues related to women and ways to deal with them.
Women are the backbone of a house. Do you think women take enough care of themselves?
We have found that ladies in any family in India tend to put their own health at secondary place. Women mainly focus on the health of their kids and other family members and make that as priority. They take a back seat when it comes to taking care of their own health. Finally when their health issues get exacerbated and when there is no option for them, only then they visit hospital for treatment. This needs to change.
Women get busy with their household chores, their children’s exams and other things, they get busy with the arrangements and they ignore their health. My message to women is to give priority to their own health as well because if the woman of the house is healthy then only other family members will be healthy too.
Infertility is the serious issue that most of the women are facing.
The important thing is that infertility is not the problem of women alone. It is the husband and wife who try to produce a child and if that is not happening then the issue or the problem is of the couple. Not just the lady but the couple comes with a history of infertility. If we see the statistics, it says in 1/3 of the couples the cause of infertility can be found in a female. In 1/3 of the couples, the cause of infertility can be found in the man and in 1/3 of the couples, the cause of infertility can be found in both. It’s not the problem for women only, it is the problem for the couple.
PCOS and PCOD are the common conditions in young girls and women. What it is and how can we treat it?
It has become common because today everybody’s life has become sedentary. Diabetes has also become common now. The reason is overweight. Same way, PCOD is related to overweight. The physical activities are reduced as we have a gadget for everything. We have a vehicle and we avoid walking. We have a remote system for changing the channel of TV. These little day-to-day physical activities of normal life have been reduced. Because of the convenience provided to us by our gadgets, physical activity has reduced a lot for most people living in towns and cities. As a result lifestyle disorders have become common like obesity, diabetes and PCOD.
In PCOD, weight of young girls increases and their monthly cycles stop and they get hair and pimples on their face. In the coming years of her life, it gets related to infertility.
The prevention is important for PCOD especially the people who have diabetic history at home, they have a greater tendency of getting PCOD. The physical activities have to be adopted. One must exercise regularly and one must have routine day-to-day physical activities.
There is a notion that women suffering from PCOD cannot conceive. How far is it true?
It’s not that a woman suffering with PCOD cannot conceive but she requires help. Many times after we provide treatment and help, then she is able to conceive. So PCOD may require some help from doctors.
We often say, PCOD increases weight of a girl but lean girls are also diagnosed with PCOD.
In lean girls, it is called lean PCO. It is also related to lifestyle related disorder. For regulating the cycles, birth control pills and symptomatic treatments are being done. If she is lean, we may not be telling her to lose weight but we tell her to be physically active.
Do birth control pills have any side effects on conceiving in future?
It’s not because of birth control pills, one can’t conceive in future but because of PCO, there can be difficulty in conceiving so PCO needs to be treated first.
Most of the girls experience spotting before and after periods. Tell us about spotting?
Spotting can be because of many things. In younger girls, it is more due to hormonal disturbances like PCOD. In older age group like women in their late 30s or 40s, it can be related to polyp in uterus and then in the 50s or 60s age group, it can be an indication of cancer. Spotting should be looked at carefully. First of all, the lady should go to the gynecologist. Ultrasound should be done and the reason behind it should be evaluated then the patient should be put on treatment.
How can spotting be treated?
For younger girls, birth control pills are prescribed. It is the right treatment but only after making a diagnosis. If the lady is in 50s then birth control pills are not given, that will in fact worsen the situation. For women having polyp, the polyps are removed first then the progesterone is given. The treatment and medication depends on the reason for spotting.
Painful periods or endometriosis is what most of the women folk experience and is often ignored as well. What should women do in painful conditions?
Endometriosis is a very common condition and it is affecting young women and girls right from 15 till 45-50 years of age. Periods get painful and some cyst gets formed in the ovary which is called blood cysts. It is not a cancerous condition. Tissues similar to the lining of the uterus get formed outside the uterus around tubes and ovaries.
During periods, the tissues bleed as well. This blood doesn’t find a way to flow out and starts collecting inside which causes pain. After a few years, when this blood collects more, it can cause a cyst in the ovaries which was earlier called chocolate cyst. These cysts are called endometriotic cysts. If the pain is severe, it should not be ignored and the girl should come to a gynecologist.
Talking about cysts, are they dangerous and need to be removed?
No, all cysts are not dangerous. Depending upon the size and requirement of the person whether she is trying to conceive or is unmarried and is having pain. Also it depends upon the size of the cyst. We can give medicine first and see the response. If the response is fine then there is no problem. If not then we need to do the surgery, remove the cyst only and not the ovary.
Fibroids are also a common issue. How should we deal with it?
Fibroids are very common. Many fibroids will not cause any problem. Many people getting diagnosed with fibroids get panicked and remove the uterus for the fear that it may cause cancer but this is not needed. Some fibroids, depending on the size and location, can cause heavy periods. At times painful periods and in that case, it needs to be removed. If the lady is young and further she wants pregnancy, so only fibroids are removed. If the woman is older like 40 plus and if there are many fibroids and the family is complete then the uterus is removed.
What are the issues that can rise with unhealthy menstrual health and how can we improve our menstrual health?
One of the big reasons is that it affects mental health. Majority of the young girls in our social system are embarrassed to talk about their periods and issues related to it with anybody. They don’t even go to the doctor and discuss the issues. They get worried about it and keep getting wrong thoughts. This causes depression, anxieties and affects mental health.
Girls with PCOD get overweight and facial hair, they are teased and labeled as fat in colleges and schools. All these things have a negative impact on their mental health. It’s important for parents that they should discuss menstrual health with their daughters from time to time. Menstrual health is natural and they need not to feel embarrassed about it.
Tell us about menopause.
Menopause is an important time period for every woman between 47 to 55 years of age. At that time, a lot of women face many issues and symptoms like hot flashes, mood swings and irritation. Women get depressed and angry. These are all hormonal changes. These hormonal changes when happen at the puberty to a teenager, everybody understands but when a menopausal woman goes through hormonal changes, nobody understands that. It is important for a lady and her family to understand that these are hormones which are causing the irritability. She feels anxious and feels like having a heart attack. In such situations, she needs a doctor’s help.
At one time, hormonal replacement therapy was in place but many studies showed that it was related to higher risk of breast cancer so it is not given causally now.
A woman can do exercises and go for a walk. She can also take up measures for good health like yoga, meditation. It’s the time when she feels overwhelmed as her parents are falling sick because they are older. Many responsibilities come on her shoulders. Her husband may be retired and children leave home for college or get married. She feels burdened and there is an inner sense of emptiness which is called Emptiness Syndrome. However this is a good time for women to pick up their old hobbies again like painting, singing and dancing.
One thing is important that if after 10-15 years of menopause, if the lady bleeds, many women are embarrassed and don’t talk about it but it is the time where the risk of uterus cancer is high. If the doctor is not consulted, it can worsen the situation. Timely consultation with a doctor can fully cure the problem.
Any message or suggestion for the women folk.
Every woman has to look after herself first. Only if she looks after herself first, she can look after her family. Just like in aircraft, it is announced that if the oxygen level falls down, a person should wear his mask first and then only help others.