Gynecology and Obstetrics Online Doctors Consultation — page 7

Hello Vandana, **Patient Information:** Name: [Your Name] Age: 20 years Sex: Female **Presenting Complaint:** The patient reports experiencing irregular periods that are often delayed, along with constant weight gain despite following a regular exercise routine and diet. She also experiences frequent bloating. The patient is concerned about her inability to manage weight effectively, despite healthy lifestyle habits. **Clinical History:** - Periods are delayed at times. - Significant weight gain over time, despite consistent efforts with diet and exercise. - Occasional bloating, which exacerbates discomfort. - No specific history of other chronic illnesses or major health concerns. **Possible Causes:** The patient’s symptoms suggest potential underlying conditions that could be contributing to her issues: 1. **Polycystic Ovary Syndrome (PCOS):** A common cause of irregular periods, weight gain, and bloating in young women. PCOS is characterized by hormonal imbalances, where higher levels of androgens (male hormones) can disrupt the menstrual cycle and lead to weight gain, particularly around the abdomen. Bloating is also a common symptom. 2. **Hypothyroidism (Thyroid Imbalance):** An underactive thyroid can lead to slowed metabolism, which causes difficulty in losing weight, weight gain, fatigue, delayed periods, and bloating. Hypothyroidism is a common cause of unexplained weight gain and menstrual irregularities. 3. **Insulin Resistance:** This often occurs with PCOS and can lead to difficulty losing weight, fatigue after meals, and bloating. Insulin resistance also affects how your body processes sugar and can cause cravings, making weight management more difficult. 4. **Stress and Sleep Disorders:** Chronic stress or poor sleep can disrupt the hormonal balance in the body, contributing to weight gain, delayed periods, and bloating. Stress impacts cortisol levels, which can lead to weight retention, particularly around the abdominal area. **Recommended Investigations:** To understand the root cause of the symptoms, the following tests should be considered: 1. **Thyroid Function Tests:** TSH, T3, T4 levels to rule out hypothyroidism. 2. **PCOS Testing:** LH, FSH, serum testosterone, and an ultrasound of the ovaries to check for cysts or other abnormalities indicative of PCOS. 3. **Fasting Insulin and Glucose Levels:** To assess insulin resistance. 4. **Complete Blood Count (CBC) and other routine investigations** to rule out any other potential causes. **Management Plan:** Based on the results of the above investigations, a treatment plan will be formulated, which may include hormonal treatments, dietary adjustments, insulin-sensitizing medications (if insulin resistance is present), and targeted exercise plans to manage weight and bloating. Stress management techniques, including mindfulness, relaxation exercises, or counseling, may also be beneficial. **Follow-Up:** A follow-up appointment will be necessary to review lab results and progress with any prescribed treatment. If any of the tests indicate a specific condition like PCOS or thyroid dysfunction, further referrals to a specialist may be recommended. Dr Shayeque Reza MD 9800280276

Hello Muneba, Thanks for sharing that—since you're just 20, the sudden change in your periods is definitely something worth getting to the bottom of, especially since they were regular before. Given your age and the symptoms (irregular cycles, shortened periods, past Nabothian cyst), here are some focused possibilities: Top Likely Causes at Your Age: 1. **PCOS (Polycystic Ovary Syndrome)** - Very common in young women. - May cause: - Irregular periods - Short, light bleeding - Acne, weight gain, or facial/body hair (but not always!) - Can be diagnosed with: - Pelvic ultrasound (to check for multiple small cysts in ovaries) - Blood tests: LH/FSH ratio, testosterone, insulin, etc. 2. **Thyroid Dysfunction** - Hypothyroidism (underactive thyroid) or hyperthyroidism can affect your cycle. - Simple blood test (TSH, T3, T4) will clarify this. 3. **Stress / Weight Changes / Diet** - Mental or physical stress, under-eating, or rapid weight changes can shut down ovulation. - This leads to shorter or missed periods. 4. **Hormonal Imbalance or Early Ovarian Dysfunction** - Although rare at your age, low estrogen or hormonal issues can cause thin endometrial lining—leading to only 1–2 days of bleeding. 5. **Post-Cyst Hormonal Disruption** - Sometimes after Nabothian cysts or minor gynecological procedures, your hormones take time to settle, especially if you were given any hormonal medication. What You Should Consider Doing: **1. Hormonal Blood Work** (done on Day 2–5 of your cycle if possible): - **FSH & LH** - **TSH (thyroid) - **Prolactin - **Estradiol (E2) - **AMH** (to assess ovarian reserve) - **Testosterone & DHEA-S** (if acne or hair issues) 2. Pelvic Ultrasound** - To check ovaries (for PCOS signs) - Endometrial lining thickness - Any structural changes after cyst healing Dr Shayeque Reza MD 9800280276

Hello Shreya, Certainly! Below is the prescription in a format commonly used in medical colleges and by healthcare professionals: **PRESCRIPTION** *Patient's Name:* Shreya *Age:* *Gender:* [Female] *Date:* 12/0425 *Diagnosis:* Fibroadenoma Bilateral, Pain, Migraine --- **1. Pain Management** - **Ibuprofen 400 mg Tablets** *Sig:* Take 1 tablet orally every 8 hours as needed for pain relief. Do not exceed 1200 mg per day. *Quantity:* 30 tablets *Refills:* 1 - **Paracetamol 500 mg Tablets** *Sig:* Take 1-2 tablets every 4-6 hours as needed for pain. Do not exceed 4 grams per day. *Quantity:* 30 tablets *Refills:* 1 **2. Hormonal Regulation (For Fibroadenoma)** - **Primosa (Evening Primrose Oil) 1000 mg Softgel** *Sig:* Take 1 softgel daily after a meal. *Quantity:* 30 softgels *Refills:* 1 --- - **Vitamin E 400 IU Capsules** *Sig:* Take 1 capsule daily. *Quantity:* 30 capsules *Refills:* 1 **3. Migraine Management** - **Sumatriptan 50 mg Tablets** *Sig:* Take 1 tablet at the onset of a migraine. If no relief, may repeat dose after 2 hours. Do not exceed 200 mg in 24 hours. *Quantity:* 6 tablets *Refills:* 1 **4. Preventive Care and Support** - **Magnesium 400 mg Tablets** *Sig:* Take 1 tablet daily for migraine prevention. *Quantity:* 30 tablets *Refills:* 1 **Instructions:** - Follow the prescribed doses. - Contact the healthcare provider if pain persists or worsens. - Schedule a follow-up consultation in 4-6 weeks to assess progress. - If symptoms of migraines or fibroadenoma worsen, further diagnostic tests (ultrasound, mammogram) may be necessary. - Avoid high-caffeine and alcohol intake. Dr Shayeque Reza MD Date- 12/04/25 9800280276

Hello Ruhi, Nothing to worry about, as I can see you high TSH which means you have hypothyroidism. And because of this you having delayed in period. For now you can do USG of Pelvis to overcome your fear. Thank you . Do give your review.

Hi kaur Can totally understand your problem Here is it what we can do : Due to your on flow menstrual blood local application is difficult and per vagina insertable tabs cant be prescribed, For presently: 1.Tab AF kit ( contains anti bacterial & anti fungal tablets) All three tablets to be taken at once after breakfast ( advised to have good breakfast) 2. Tab Esomac Dsr daily once before food for 3days . After your periods have completed Use Candid V cream local application at your private parts Candid V pessary set of 7 tablets One tablet per vagina every night for 7days ( advised to wash it in morning) Maintanence of personal hygiene is very important ( shaving of pubic hairs ) Avoid using tight underwears And always use totally dry and properly washed undergarments Hope so I have resolved your problem

Hey Sahana I’m really sorry you’re dealing with that ,it sounds incredibly uncomfortable, especially on top of everything else. Vaginal boils can be painful and stressful, both physically and emotionally. Probably the diagnosis is Bartholin cyst. It's often caused by a blocked hair follicle, ingrown hair, or bacterial infection (like Staph). It starts as a red, tender bump and may grow larger, fill with pus, and become more painful over a few days. How to care for it at home (gently and safely): Warm compresses: Use a clean, warm, damp cloth and gently press it against the boil for 10–15 minutes, 3–4 times a day. This can help it drain naturally and ease pain. Keep the area clean & dry: Wash gently with warm water and mild soap. Avoid any harsh scrubbing or scented products. Wear loose, breathable underwear (cotton is best): Avoid tight clothing to prevent friction and help healing. Don’t pop it. As tempting as it might be, squeezing it can push bacteria deeper and worsen the infection. IF YOU HAVE FEVER, CHILLS YOU MIGHT NEED PROPER FOLLOW UP.

Ok I can understand your problem. Feel free to interact. This is Called Vaginitis which is very common with women. Please let me know if you have past history of any chronic illness like Diabetes Mellitus, TB and if your pregnant. As you told it is itchy and you have white discharge without any foul smelling, then probably it is Vaginal candidiasis. Both the partner needs anti fungal treatment.

Patient Name: Shrutika Lakadkar Age: 22 years Date: [13/04/25] Chief Complaints: No significant increase in breast size despite weight gain (from 35kg to 48kg) Low self-confidence due to breast size not increasing with weight gain Previous treatments not showing results Diagnosis Considerations: Hormonal imbalance or lack of response to weight gain in breast tissue Insufficient muscle tone in the chest area Emotional and psychological impact of breast size on self-esteem Blood Tests: Hormonal profile (Estrogen, Progesterone, Testosterone, FSH, LH) to check for any imbalances Thyroid function test (TSH, T3, T4) to rule out thyroid-related issues that may affect metabolism and fat distribution **Follow up the reports as soon as possible so that I can plan a treatment ** Dr Shayeque Reza MD 9800280276

Hello Bazila, OPD PRESCRIPTION Name: Bazila Age/Sex: 18 years / Female Date: 12/04/25 Weight: Thank you for sharing that — it sounds like you're dealing with a really frustrating and painful situation. You’ve been doing everything right by getting tests done and watching your lifestyle, yet you're still experiencing symptoms that deeply affect your daily life and confidence. Chief Complaints: Irregular menstruation (last period: early February) Progressive weight gain despite healthy diet Hirsutism (excessive facial and body hair) Androgenic alopecia (scalp hair loss, balding) Inability to lose weight despite efforts Provisional Diagnosis: Oligomenorrhea with Clinical Hyperandrogenism — likely Subclinical or Phenotypic PCOS / Insulin Resistance (with normal labs) Let’s break it down clearly: Your Symptoms: Irregular periods (no period since early February) Belly bloating or "hanging" sensation Rapid or persistent weight gain despite clean eating Hirsutism – excessive facial and body hair Hair thinning/balding (likely androgenic alopecia) Difficulty losing weight despite efforts All blood tests (PCOD profile, CBC, TFT, USG) are reported as normal What Could Be Going On? You could still have a hormonal disorder that isn’t fully showing up in basic blood tests yet. Some forms of PCOS, especially lean or subclinical PCOS, don’t always reflect clearly in: Ultrasound (ovaries may appear normal) Testosterone (may still be in “normal” range but on higher side) Basic insulin/glucose levels You may have Insulin Resistance without diabetes — very common in women with your symptoms. Metabolic dysfunction can lead to: Fat accumulation around belly Weight loss resistance Increased androgens (causing hair issues) Non-classic Congenital Adrenal Hyperplasia (NCAH) or androgen-secreting issues (very rare but worth ruling out) These don’t always show up in general PCOD profiles They require specific tests like 17-OH Progesterone, DHEAS, and Free Testosterone Hypothalamic dysfunction or chronic stress can also disturb hormonal signals without showing in initial tests. What Can You Do? Even if reports are normal, your symptoms are clinically significant and deserve treatment. Dr Shayeque Reza MD 9800280276.

Hello Babli You’re carrying so much right now—physically, emotionally, hormonally. What you’re describing isn’t just random symptoms; it sounds like your body is waving red flags, asking for attention and support. Let’s gently break this down together and look at what might be going on, because there’s a strong possibility that it’s hormonal imbalance, maybe something like PCOS, thyroid issues, or even perimenopause, depending on your age. But regardless of labels, your experience is valid, and you deserve to feel better. Here’s what your body might be trying to say: 1. Weight gain (especially belly/thigh/waist) + bloating + joint pain These can point to hormonal imbalances (like insulin resistance, PCOS, or low thyroid). Feeling heavy even when not eating is often tied to inflammation, sluggish digestion, or hormonal water retention. 2. Low, brown/yellow period flow + irregular cycles This might suggest: Estrogen dominance (too much estrogen compared to progesterone) Perimenopause if you’re late 30s or 40s Thyroid dysfunction—hypothyroidism often causes light, irregular periods. 3. Headaches, nausea, fatigue, not able to eat These often come from gut issues, chronic stress, or again—hormones. Could also be linked to IBS or poor nutrient absorption (like low iron, B12, or magnesium). Things you can do now (gently, no pressure): 1. Get lab tests done if possible: If you’re up for it, ask your doctor to check: Thyroid panel (TSH, T3, T4, antibodies) Hormones (estrogen, progesterone, testosterone, LH, FSH) Vitamin D, B12, iron, CRP (inflammation) Insulin & fasting glucose Supportive things to do at home: Gentle movement daily (even stretching or walking)—helps joint pain, hormones, and digestion Warm, easy-to-digest meals (soups, stews, veggies + healthy fats + protein) Magnesium supplement (great for hormones, IBS, sleep, and joint pain) Stay hydrated, but avoid cold drinks—they can worsen bloating for some Got it! Based on everything you’ve shared—and since your periods are coming but the **flow is very low**, and you’re dealing with **hormonal imbalance, IBS, fatigue, joint pain, and vaginal boils**—here’s a **gentle daily routine with suggested medicines, supplements, and self-care practices** to help support your healing. --- ### **Daily Wellness Plan (Natural + Medical Support)** **(Feel free to screenshot or copy this)** --- ### **Morning (Empty stomach – after waking)** - **1 glass warm water** with a few drops of lemon (optional: pinch of turmeric) - **1 capsule: Myoinositol + D-Chiro Inositol** (e.g., Ovacare Myo / Normoz / OvaBoost) *Supports hormonal balance, weight, ovulation* --- ### **After Breakfast** - **Vitamin D3 + B12 + Iron supplement** *(e.g., Neurobion Forte + Shelcal-D or similar)* - **1 capsule Omega-3** (anti-inflammatory, supports joints and hormones) - **Probiotic capsule** (e.g., Darolac / VSL#3) *Supports gut, reduces IBS, improves immunity* **Breakfast Idea:** Warm khichdi, oats, poha with veggies, or eggs + toast *(Avoid cold/raw or heavy fried foods in the morning)* --- ### **Mid-morning (Optional)** - **Ashwagandha capsule or tea** (stress + hormone support) *(Skip if it worsens IBS)* --- ### **Lunch** - Warm, cooked meals—dal, rice, veggies, ghee, or roti + sabzi - Add **cumin + ajwain + ginger** in cooking to help digestion - Sit calmly during meals—no phone/stress eating --- ### **Post-Lunch** - **Liv52 tablet or syrup (Himalaya)** – supports liver, reduces bloating --- ### **Evening (Pre-dinner)** - **Peppermint tea or chamomile tea** – soothes digestion, helps calm mind - **Gentle walk or light stretching** – improves digestion, relieves joint tension --- # **Dinner** - Light meal – soup, khichdi, steamed veggies + moong dal *(Avoid cold drinks, heavy spices, sugar)* ### **Night (Before Bed)** - **Magnesium glycinate or citrate** supplement (relaxes muscles, eases sleep, supports digestion + headaches) - **Warm compress** on belly or joints if pain or bloating - **1–2 Himalaya Evecare capsules** *(regulates hormones, supports menstrual flow)* **Optional:** - Body scan meditation or deep breathing to quiet thoughts - Keep lights dim and phone off 30 mins before bed ### **Bonus Tips:** - Track your cycle, mood, and symptoms daily (can help your doctor too) - Drink warm water through the day, not cold - Try not to skip meals—it can worsen hormones and IBS This plan is **a supportive base**, not a cure—but many women see improvement in energy, flow, digestion, and mood over 2–3 cycles with this kind of care. If you're okay with it, I can also help write a message you can take to a gynecologist or general physician to ask for blood tests or confirm these meds. Want that? And if there’s one symptom that’s bothering you the most *right now* (like nausea or pain), I can suggest more targeted relief too.