Other Services:

Growing Older, Becoming more wiser and more Experienced
While all women will experience menopause, each will experience it in her own unique way. For many women the transition is an easy one. For others, menopause comes with some decidedly unpleasant side effects. Regardless of ease or difficulty during menopause, however, the risks of long term health problems (such as heart disease and osteoporosis) increase post-menopause.
Your Doctor's Role:
It’s your doctor’s task to help you make a smooth transition into menopause and beyond: On

Many women find menopausal and post-menopausal life to be liberating. No monthly bloating, cramping, tampons or pads. No pregnancy concerns. Don't be afraid of this stage of your life. Both short and long term conditions can be managed with the help of your doctor.
You can email your queries to Dr. Parulben Shah or Dr.Pragnesh Shah or meet her in person at their Clinic.

Top

What is PCOS?
Polycystic ovary syndrome (PCOS) is a mild hormone imbalance that can cause irregular periods, unwanted hair growth, and acne. It can be mild or severe. This is a common condition that begins during the teenage years. In fact, almost one out of fifteen women has PCOS.
What are the signs of PCOS?
Adolescents with PCOS can have a range of signs. Some of the most common include:

Could I have PCOS?
If you have some or all of the above symptoms, you might have PCOS. There are also other reasons why you might have these signs and symptoms. Only your doctor can tell for sure. If you do have PCOS, you'll want to know what causes PCOS, how it works, and how to treat it. Read on for more information and answers to your questions!
What causes PCOS?
PCOS is caused by an imbalance in the hormones (chemical messengers) in your brain and your ovaries.

For a more detailed explanation, take a look at the figure below:

PCOS occurs when these hormones don't communicate appropriately. Specifically, the pituitary gland makes too much LH. In turn, this causes your ovaries to start to make extra testosterone.
Why are my periods so irregular?
Having PCOS means that your ovaries don't get the correct hormonal signals to allow you to have your period once a month. To answer this question in more detail, first let's look at the cycle of a normal menstrual period.

Now, let's look at why having PCOS means that you don't get your period regularly. Remember that your LH levels are much higher than your FSH levels. The LH surge that is supposed to come once a month does not occur. This finding, combined with the extra testosterone in your blood, keeps you from ovulating. The diagram above shows that the whole cycle stops just before ovulation. As a result, women with PCOS have irregular periods (too frequent or late) or don't get their periods at all.
What are these cysts on my ovaries?
The term "polycystic ovaries" means that there are lots of tiny cysts, or bumps, inside of your ovaries. Not all women with PCOS have these cysts. Even if you do have them, they are not harmful and do not need to be removed.
Why do I get acne and/or extra hair on my body?
Acne and extra hair on your face and body can be the result of slightly too much testosterone. All women make testosterone. If you have PCOS, your ovaries make a little bit more than they are supposed to, or your body is more sensitive to testosterone. Testosterone tells your hair follicles to "turn on,” causing hair growth. Testosterone also affects skin cells, resulting in acne.
Why do I have patches of dark skin?
Many adolescents with PCOS have higher levels of insulin (a hormone) in their bloodstream. This can sometimes cause patches of darkened skin on the back of your neck. This hormone may also send a signal to your ovaries, resulting in their making extra testosterone.

Top

WHY AND WHEN TEEN AGE GIRL SHOULD CONTACT DR.PARULBEN OR DR.PRAGNESH

Q – Why visit Dr. Parulben?

A.  Dr. Parulben Shah has a daughter of teen age, understands better as a mother & Gynaecologist and she also sees lots of teens and specializes in adolescent Gynaecology. Your issues and concerns are different than your mom’s and need special attention and care, that too under high level of CONFIDENTIALITY. Ask people you trust for references – your family doctor, your mom, aunt, older sister, your school or college best friends and the surroundings – you will get the answer yourself.

Q - When should I schedule my first appointment and how often should I follow up afterward?

A. Your first appointment should be between 13 & 19 years of age (Menarche: Age at which menstrual period usually starts). This should depend on whether you have any health concerns like cramps during periods, emotional ups & downs, irregular periods, family medical history or any abnormal symptom that makes you feel the necessity of medical attention. You and Dr. Parulben can work out a schedule for follow-up visits that work for you. If you’re sexually active or over 18 you should make an appointment every year (this is really important!).

Q – What will happen during my first visit?

A. Your first visit will help you to understand Pubarche (Age at which puberty- changes of youth starts) .Your first visit will open an opportunity for you and Dr. Parulben to know each other and for the doctor to understand and record your health history. Your height, weight and blood pressure will be checked and you may be asked to provide a urine sample. Depending on your age, health history and any concerns you may have, the doctor might do a breast exam, pelvic exam and Pap test.

Q – How do I talk to Dr. Parulben?

A. Asking and answering quarries and myths, no matter how personal, is the key to getting good care. Remember, it's really important to be honest. That’s the only way your doctor will know what to check and whether you might need special tests. What you say is confidential, just between you and your doctor. Your doctor will be happy to describe procedures, so don’t hold back. Ask whatever is on your mind. Your doctor will probably tell you that there are no stupid questions.

Q – Will the exams hurt?

A. Most of the time it will be counseling only. Check up will be required in very rare case relevant to your problem. You’ll probably experience a feeling of slight pressure rather than pain during the exams. Some discomfort might be caused by muscle tension, so it’s good to concentrate on relaxing. If you do feel pain, speak up right away.

Q – What happens when my appointment is over?

A. If you’ve had tests, Dr. Parulben will let you know when the results will be back. It’s a good idea to schedule your next appointment before leaving.
Congratulations!! You can now leave Dr. Parulben’s Clinic much relaxed and mentally strong knowing you’ve done something good for yourself.

 Top

What is endometriosis?

Endometriosis is a condition that occurs when tissue similar to the lining of the uterus is found outside its normal location.
Common locations of endometrial implants include the ovaries, Pelvic walls, and Uterosacral ligaments that support the uterus and tissue covering the bladderand rectum. The location of the endometrial implants and the way in which the lesions affect the pelvic organs contribute to the symptoms adolescent and adult women may have. Severity of pain varies with extent of Endometriosis (Mild, Moderate, and Severe)

Symptoms of endometriosis

Occasional or constant pelvic pain and/or severe period cramps are definitely the most common symptoms. There can be pain before, during or after your period. The pain may occur at regular times in your cycle or the pain may occur at any time during the month. It is often referred to as "chronic" pelvic pain. Some teens may have pain with exercise, sex, and/or after a pelvic exam. Painful or frequent urination, diarrhea or constipation may accompany the pelvic pain. Dyschasia indicates pain during defecation indicates recto-vaginal Endometriosis.

How is endometriosis diagnosed?

If you have unexplained pelvic pain, menstrual cramps that are so bad that you miss school, or pain when you have sex, you could have endometriosis.
There could be other reasons for your symptoms too. Only your health care provider can tell for sure. In fact, the ONLY way to be 100% certain of this diagnosis is to have a procedure called a “laparoscopy”.
A laparoscopy allows your doctor to look inside your belly at your pelvic organs with a special lens to identify the endometriosis (implants). Other tests that MAY be ordered by your health care provider BEFORE a laparoscopy might include blood tests, cultures to check for infection, ultrasound or an MRI (to make sure it's not something else).
If you think you could have endometriosis, you will want to find a qualified Gynaecologist to evaluate you. Most of the time Endometriosis is treated with medicines in teens. Rarely operation in the form of laparoscopy is requires in teens.

What causes endometriosis?

Although we know that some young women may be slightly more likely to develop endometriosis because female relatives have it, the truth is we do not know the cause of this disease.
So Females with Family history of Endometriosis are advised to get married as early as possible and try pregnancy as early as possible as pregnancy is known to relive her from pain of Endometriosis and the diseases itself.
The three most accepted theories are:

What can I do if I think I might have endometriosis?

While we can't cure endometriosis fully, you can be treated for your symptoms.
If you are having pelvic pain or unexplained period cramps which cause you to be absent from school several days a month, you may want to keep a record of your symptoms.
You can also identify your pain by writing a pain diary. Ways to help you describe your pain:

Next, talk to your gynecologist about your symptoms and bring your pain diary with you for your doctor to review. It's a good idea to bring copies of test results, operative notes (a summary by your doctor if you have had surgery) and/or radiology reports (you can ask for copies of these too from the x-ray department of the health care facility where you had your ultrasound or x-ray). Most importantly, make sure you are evaluated by a gynecologist who specializes in taking care of teens with endometriosis.
A research study done at Children's Hospital in Boston found that endometriosis was the most common diagnosis after surgery in teens that had chronic pelvic pain.
Never forget to preserve video of your laparoscopic surgery for Endometriosis from your Doctor for future prognosis and Infertility treatment.


What kinds of treatment are available?

Talk to your gynecologist about treatment options. When an evaluation by your gynecologist suggests endometriosis, it is likely that you will be scheduled to following options:

What else do you need to know about endometriosis?

The goal of the treatment should be aimed at relieving pain, controlling the progression of the endometriosis and preserving fertility for future childbearing. Treatment can make a big difference in improving the quality of your life.
Medical science is constantly moving ahead. Ask your health care provider about more information about teens with endometriosis.

Top

It’s very unfortunate that educated female becomes pregnant just because they are not aware or not using Family Planning methods properly.

The result is unwanted pregnancy and any termination of pregnancy is illegal as also damaging to her reproductive health in future.

Dr. Parulben Shah’s Clinic offers a useful, cafeteria approach to the patients for avoiding unwanted pregnancies. Patients may choose non-permanent measures like Oral Contraceptive pills, barrier methods, I.U.C.D., injectable contraceptives (Depo-Provera) or permanent methods, that is, voluntary sterilization.
 
 Non-permanent methods:

Permanent methods:
Voluntary surgical procedure for permanently terminating fertility in women

Methods

Mechanism of Action

When to Perform

Appropriate for

Method Characteristics: Benefits

Non contraceptive Benefits

Method Characteristics: Limitations

Advantages of Laparoscopic Tubal Ligation:

6. Urine leak on Coughing-SUI:
If you are a lady over 30 years, you must read this