Sunday 4 January 2015

Continuous bleeding after emergency contraceptive pill


Emergency contraceptive pill should be used for emergency purpose only.
Because repeated and frequent intake of emergency contraceptive pills can lead to menstrual irregularities.
There should be at least two months gap between two pills.
Frequent intake of emergency pills can cause prolonged bleeding in some women as a side effect.
If bleeding doesn't get controlled even after one week, better to consult gynecologist once and get examined.
Antifibrinolytic drugs can help in controlling the bleeding to some extent.
If bleeding is doesn't get controlled with them, hormone pills may be needed.
To prevent these side effects regular contraceptive methods are advisable to couple with history of frequent intercourse. 

Saturday 3 January 2015

Causes of secondary infertility


If couple who are fertile once
(having first child or children or with previous miscarriage), not able to conceive again for one year with regular unprotected intercourse history, that is called secondary infertility.

The possible causes of secondary infertility are:
Gonadal hormonal imbalance which can cause irregular menstrual cycles, anovulation etc
Fallopian tubal block
Uterine causes like endometrial abnormalities, fibroids, adhesions etc.
Thyroid hormonal or prolactin level abnormalities giving rise to irregular periods etc.

Male factors can also lead to secondary infertility like:
Abnormal seminal parameters like low sperm count, decreased motility etc.
Genital abnormalities like varicocele, ejaculatory duct obstruction etc.
 By examination and by investigations like ultrasound, hysterosalpingography, gonadal hormonal analysis, thyroid profile, prolactin levels estimation for female partner and by physical examination and semen  analysis for male partner the possible cause of the problem can be identified and treated. 

Feeling periods as burden?


Some women think that having periods monthly is a burden to their life.
As they have completed their families or they don't want pregnancy, they want to get rid of periods either by hysterectomy or by other methods.
But this is not correct.
Because the gonadal hormones which are responsible for regular menstrual cycles, also help in many other functions of the body like cardiac function, bone health, neurological function etc.
Having uterus is important for gonadal function. Because if end organ is lost, ovaries function will get affected.
So having menstrual cycles is important for general health also.

Friday 2 January 2015

Subchorinic hematoma

Live fetus with subchorionic hematoma
Subchorionic hematoma is collection of blood between chorion and uterus.
This is a common ultrasound finding in early pregnancy.
 The possible causes of subchorionic hematoma are   damage of the surrounding blood vessels by growing  gestational sac, during the process of abortion separation of gestational sac can lead to collection of blood etc.
Usually small subchorionic hematomas will get absorb soon.
But if pain abdomen, bleeding per vaginum etc occurs there is possibility of miscarriage and needs evaluation.
 Ultrasound should be repeated after two to three weeks, which can help in finding out whether hematoma got absorbed or not.