Gynecology and Obstetrics Online Doctors Consultation — page 6

1) Ovulation Predictor Kits (OPKs) Test daily starting from day 10 to day 14 of your cycle to detect the LH surge. Use the test to time intercourse more accurately. Tests: Thyroid Function Test (TSH, T3, T4) Hormonal Profile: FSH (Follicle Stimulating Hormone) LH (Luteinizing Hormone) Estradiol Progesterone pelvic ultrasound Follow up with the reports Thank you

It’s a series of treatment needed to have control on it. Better get a paid consultation of mine.

PCOS with persistent anovulation Subclinical hypothyroidism (TSH target <2.5 mIU/L for conception) History of secondary infertility Obesity contributing to hormonal imbalance

Patient Name: Neha Yadav Age: 30 years Date: [13/04/25] Chief Complaints: Prolonged bleeding (continuous menstruation) White, heavy discharge with a strong odor Itching and irritation in the intimate area Soaked clothes due to excessive discharge Diagnosis Considerations: Hormonal imbalance (e.g., PCOS, thyroid disorders) Vaginal infections (e.g., bacterial vaginosis, yeast infection) Uterine pathologies (e.g., fibroids, polyps) Vaginal hygiene concerns Treatment Plan: Blood Tests: Complete Blood Count (CBC) Thyroid function test (TSH, T3, T4) Hormonal profile (LH, FSH, estrogen, progesterone) Glucose levels (to check for diabetes) Ultrasound (Pelvic): To assess for any uterine abnormalities (fibroids, polyps, endometriosis, etc.) * Please do the test so that I can Plan your treatment * Follow up as soon as possible * Dr Shayeque Reza MD 9800280276

Hello Kaur, Don’t worry I can understand your problem, and I am here to help you out. Patient Name: Vishaldeep Kaur Age: 26 years Date: 12-April-2025 Chief Complaints: Irregular periods with short duration (2 days), delayed cycles, recent UTI, vitamin D deficiency, occasional stress. Concerned about possible PCOS/PCOD Clinical Impression: The pattern of short and delayed periods, coupled with general fatigue (likely from vitamin D deficiency) and occasional stress, may point toward a mild hormonal imbalance, but this alone doesn’t confirm PCOS or PCOD. Menstrual irregularity can be due to multiple causes, including: Functional Hypothalamic Dysfunction – Caused by stress, irregular sleep, or nutrition imbalances. PCOS/PCOD – Diagnosed by symptoms (irregular cycles, acne, weight gain, excess facial/body hair, hair thinning) and confirmed by ultrasound and hormone profile. Post-infection or temporary disruption – Recent UTI or any systemic illness can affect your cycle for a short term. Suggested Diagnostic Workup: To evaluate for PCOS or hormonal imbalance, the following tests are recommended: Pelvic ultrasound – To check for polycystic ovaries Hormonal Profile: LH, FSH (Day 2–5 of your cycle) TSH (thyroid) Prolactin AMH (Anti-Mullerian Hormone) Testosterone (Total and Free) Vitamin D level – If not recently repeated CBC and CRP – To rule out low-grade inflammation Management & Advice: Vitamin D correction: Tab. D3 must 60,000 IU – once weekly for 6 weeks (under guidance) Sunlight exposure 15–20 mins/day Menstrual regulation: Track your cycles using an app or calendar Consider low-dose OCP or cyclical progesterone (only after proper evaluation if PCOS confirmed) Lifestyle Modifications: Regular physical activity (brisk walk/yoga 30 min/day) Balanced diet with more protein, fiber, and healthy fats Reduce processed sugar and refined carbs Manage stress through mindfulness/meditation If periods remain irregular for more than 3 months, a gynecologist/endocrinologist consultation is advised for tailored hormonal therapy. Conclusion: It is too early to confirm PCOS based on just delayed or 2-day periods. A proper diagnostic workup is needed. Your current symptoms could be due to temporary stress, nutrient deficiency, or minor hormonal fluctuation. With a few tests and lifestyle care, things can be improved significantly. *Follow Up with reports* Dr Shayeque Reza MD 9800280276

Patient Name: Kajal Age: 22 years Date: 12-April-2025 Chief Concern: Delayed menstruation – Last period in mid-February; no period in March or April (until 12th); pregnancy test on 8th April was negative. No current stress. Clinical Impression: A missed or delayed period in an otherwise healthy young woman can occur for several reasons other than pregnancy—especially if your pregnancy test was negative after a reasonable window. Since you're not under stress, some possible explanations include: Anovulation (absence of ovulation during a cycle): This can occur occasionally even in women with regular cycles. Hormonal fluctuations: Thyroid dysfunction, elevated prolactin levels, or mild PCOS can cause delayed ovulation or skipped periods. Weight changes: Even without noticeable gain/loss, small shifts in diet, physical activity, or body fat percentage can affect menstrual hormones. Post-viral or immune response: Sometimes, a recent viral illness or minor systemic imbalance can disrupt the cycle temporarily. Medication or supplement use (if any): Certain drugs or supplements can interfere with hormonal balance. Advice & Recommendations: Repeat pregnancy test around 14th April to rule out late implantation. If still negative and no periods by 20th April, consider consulting a gynecologist. They may advise: Hormonal blood tests: TSH, Prolactin, LH, FSH Pelvic ultrasound: To check ovarian function and uterine lining Lifestyle check: Ensure consistent sleep patterns and regular meals Avoid over-exercising or undereating If periods still don’t resume, a short course of hormonal medication may be prescribed to induce withdrawal bleeding — but only after evaluation. Conclusion: One skipped period without other symptoms is usually not a serious issue. However, if your cycle becomes consistently irregular, it’s advisable to look deeper into hormonal health. For now, monitor your symptoms, stay hydrated, maintain a balanced routine, and recheck your pregnancy test if needed. Do let me know if you need paid consultation. Dr Shayeque Reza MD 9800280276

Hello Rinu, Patient Name: Rinu verma Age: 22 years Date: 12-April-2025 Chronic Illnesses: None reported Chief Concern: Menstrual cycle length varies between 28 to 45 days. Periods last for 5 days with no pain or nausea, but significant bloating is present during menstruation. Clinical Impression: Your menstrual cycle, although sometimes reaching up to 45 days, can still be considered within the broader spectrum of normal if: Ovulation occurs regularly Periods are not excessively heavy or painful There are no signs of hormonal imbalance (acne, facial hair, significant weight changes, hair thinning) Cycles ranging from 21 to 35 days are typically considered normal, but occasional longer cycles (up to 45 days) may occur due to stress, dietary changes, lifestyle shifts, or mild hormonal fluctuation. If this pattern is consistent over time, it could indicate a tendency toward mild ovulatory irregularity, possibly related to subclinical PCOS or luteal phase defects, though not always pathological. Advice & Investigations: Menstrual calendar tracking – Note cycle length, flow, mood changes, and ovulation signs for at least 3 months. Hormonal Profile (if cycles remain inconsistent): LH, FSH Prolactin TSH AMH Testosterone (Total and Free) Pelvic ultrasound (to assess ovaries and endometrial thickness) Lifestyle review – Sleep, stress, and dietary habits play a role in hormonal regulation. Management & Recommendations: Diet: Balanced diet rich in fiber and complex carbs Include leafy greens, nuts, flaxseeds, and foods high in magnesium and B6 (for bloating relief) Hydration: Drink 2.5–3 L/day to reduce bloating and improve circulation. Exercise: Moderate physical activity 4–5 days/week (yoga, walking, light cardio). For Bloating: Tab. Meftal Spas – Only if bloating is painful (not daily) Peppermint tea or fennel water may help naturally Avoid carbonated drinks, refined sugar during luteal phase Stress management: Sleep hygiene, mindfulness/meditation 10 mins daily For more follow ups you can contact me. You need close monitoring and follow ups. Do give your review. Dr Shayeque Reza MD 9800280276

Patient Name: Harman Age: 25 years Gravida: G2 (Second Pregnancy) Gestational Age: 26 Weeks Date: 12-April-2025 Chronic Illnesses: None reported Chief Concern: Mild nosebleeds during the 26th week of pregnancy. Concerned if this is normal and whether any other changes should be expected in this stage. Clinical Impression: At 26 weeks of pregnancy, several physiological changes occur in the body due to increased blood volume and hormonal influence. Mild nosebleeds (epistaxis) are common and usually harmless in pregnancy, especially in the second and third trimesters. This happens due to: Increased blood flow and vessel sensitivity – Pregnancy hormones like estrogen and progesterone increase blood flow to mucous membranes, making nasal blood vessels more fragile. Dry nasal passages – Often caused by weather changes, air conditioning, or dehydration, which can worsen nosebleeds. Minor trauma – Like nose picking or blowing the nose too hard. Advice and Reassurance: Stay hydrated – Drink plenty of water to keep mucous membranes moist. Use a saline nasal spray – Keeps nasal passages moist and reduces dryness-related bleeding. Humidifier at night – Helps prevent dryness from indoor air. Avoid blowing nose forcefully or picking nose. Cold compress on the nose bridge during bleeding episodes helps constrict vessels. Sleep in a slightly elevated position to reduce nasal pressure. Warning Signs (When to Seek Medical Attention): Frequent or heavy nosebleeds Bleeding that doesn’t stop after 10–15 minutes of applying pressure Bleeding with high blood pressure, dizziness, or vision changes Any signs of anemia (excessive tiredness, pale skin, breathlessness) Other Common Changes at 26 Weeks: Baby's movements become more regular and stronger Backache or pelvic discomfort Leg cramps or mild swelling in feet Increased heartburn or constipation Emotional mood swings or vivid dreams Next Steps: Continue prenatal vitamins (Iron, Calcium, Folic Acid) Maintain left-side sleeping position Monitor fetal movements daily Attend regular antenatal check-ups Optional: Blood pressure check and hemoglobin level (to rule out anemia if bleeding is frequent) You are doing great. Don’t worry mild bleeding is normal. Please rate and review. For consultation do reach me. Dr Shayeque Reza MD 9800280276

Thank you for sharing this, Harman. Based on your description, what you're experiencing is commonly seen in the second to third trimester of pregnancy especially around 26 weeks. Antenatal Follow-Up Note Patient Name:Harman Age:25 years Gravida :G1 (assumed, please confirm if not first pregnancy) Gestational Age:26 weeks Chronic Illnesses:None Date:12-04-2025 Chief Concerns: 1. Occasional right-sided abdominal/stomach pain 2. Pressure sensation while sleeping, especially at night 3. Pain in the right leg 4. Anxiety about whether this is normal in pregnancy Clinical Impression: Your symptoms are likely part of normal physiological changes in the second and third trimesters due to: 1. Round ligament pain– sharp or pulling sensation on one or both sides of the lower abdomen, more common on the right side. Caused by stretching of the ligaments that support the growing uterus. 2. Sciatic nerve pressure or pelvic girdle pain– the growing uterus can compress the sciatic nerve, causing leg or lower back pain (often one-sided). 3. Uterine pressure– normal as the uterus expands and shifts position. This may worsen at night due to sleeping posture. 4. Baby's position– can cause pressure in different areas at different times. Reassurance & Advice: - These symptoms are common and usually not dangerous if there are no red-flag signs. - Try left lateral sleeping position to reduce pressure on the inferior vena cava (a large vein). It improves circulation to baby and reduces pressure. - Use pillows between knees and under the belly while lying down for support. - Warm compress (not hot) can help relax muscles on the painful side. - Gentle stretching or prenatal yoga can relieve ligament and back discomfort. - Avoid standing or sitting for long period– shift positions frequently. When to Seek Immediate Medical Attention: If you have any of the following: - Severe or sharp constant pain (not relieved by rest) - Vaginal bleeding or fluid discharge - Fever or chills - Decreased fetal movement - Sudden swelling of feet, face, or hands - Headaches or visual changes Follow-Up Plan: - Routine antenatal visit as scheduled - Obstetric ultrasound (as per schedule or if advised for pain) - Monitor baby’s movements daily - Keep hydration adequate - Maintain iron and calcium supplements * PLEASE GIVE YOUR REVIEW . Thank you Dr Shayeque Reza MD 9800280276

Please share your problem properly I am here to help you. Dr Shayeque Reza Md 9800280276