Girls are not meant to suffer: Dr Lalita Badhwar

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 Medalist from Maulana Azad Medical College, a premier Medical college of India, she has super specialized in the field of Gynaec Laparoscopic surgery for which she received training in Germany.

On International Day of Action for Women’s Health 2022, Dr. Badhwar talks  to Rising Kashmir’s feature writer, Insha Latief Khan about menstrual health, hygiene and common issues faced by women while advocating on shunning the social stigmas associated with it.

 

What are the different types of vaginal discharge and what each discharge means?

The discharge that happens at the time of ovulation, that means in the middle of the cycle or the time between the two periods is normal. It lasts for two to three or four days. It is an indication of the formation of eggs and that discharge is normally colorless and odorless. It is slightly mucoid. Some girls get a discharge right before periods. These discharges are normal and not alarming and the discharges are normal to happen.  If much discharge is happening and has a white color like that of a cream or curd and also causes irritation, it usually indicates infection. One of the common infections is yeast infection. This happens usually due to sexual transmission but can happen otherwise too. Another cause of it is usage of antibiotic drug. If taken for a longer time, the good bacteria of the vagina die and the yeast increases. One should consult a doctor and take anti-fungal treatment from the doctor. The yeast infection is common in diabetics. Most ladies suffering from the problem don’t know that they have diabetes and we put them on yeast treatment and simultaneously tell them to check their blood sugar. On checking, it comes to know that their blood sugar is high so its yeast infection. Another infectious discharge is light cream in color. The smell of the discharge is fishy and also causes irritation which is called Trichomonas discharge. It happens due to sexual transmission and doctors should be consulted for treatment.  Greenish discharge is also infectious and that has to be seen by a doctor. The brown discharge that happens before and after the period is normal but if it happens in the middle of the cycle, then a doctor has to be consulted. In case of irritability or odorous discharge, they should meet a doctor. 

 

What can be the causes of vaginal infections?

Vaginal infections are caused usually due to sexual transmission, yeast infection, diabetes and long use of contraceptives pills, people who take steroids for asthma can also develop vaginal infections.

 

Some women also get infection in fallopian tubes. How can it be treated?

Infection in tubes can happen due to a number of reasons. The common reasons are tuberculosis or Chlamydia. Tubes in such condition can be fully or partially blocked which can cause the problem in conception. Chlamydia infection is sexually transmitted. Like tuberculosis can happen anywhere in the body, genital tuberculosis can happen too. Its treatment depends on the underlying cause. If tubes get blocked then we can perform laparoscopy to open them. It gets impossible to open some tubes when they get blocked. If tubes cannot be opened and the couple wants to conceive then IVF is the option.

 

How can we maintain menstrual hygiene?

Hygiene is very important. Inner douching should not be done. Washing with mild soap or with vaginal washes which are PH balanced can help. Use the vaginal wash twice a day – in the morning and before going to bed. We should not put anything inside vagina for cleaning as it can disturb the PH value and further cause the infection. After passing urine, use tissues so that the vagina remains dry. Dampness can also cause infection.

 

There is a stigma associated with the menstrual cycles which doesn’t let women and girls live a normal life. What should be done?

The stigma associated with menstruation should be rejected. It’s a normal body process. Just like passing urine and motion, periods are a normal cyclical process and come to every girl and woman. There is nothing to be ashamed of. It’s not like that a girl while on her periods shouldn’t go anywhere or shouldn’t involve herself in daily activities. These things have been made to oppress women and to control them. One of the old notions is to avoid eating sour food during periods. Such things don’t have any connection with the periods.

 

There are a number of menstrual products available in the market. Which one is better?

Girls should not wear synthetic pads which can cause allergic reactions and irritation. One should use pads with cotton lining as the pads with synthetic lining are not good. The changing of pads depends on the flow. For heavy periods, change the pad frequently. After 4-5 hours, you should change the pad. There are also reusable cloth pads available in the markets and they can be used but it must be washed properly and dried in bright sunshine. Tampons are also a good option and can be used by anyone. Even unmarried girls can use this but tampons are more comfortable for people who are sexually active. The only thing is it’s important to change the tampon in 3-4 hours. If you forget the tampon inside then it can cause severe infection which can spread in the whole body. We call it Toxic Shock Syndrome (TSS). The thing is if someone uses a tampon at the end of the period, they may have a chance of forgetting it inside so it’s better that in the last days of the period, pad should be used instead of tampons.

 

What about menstrual cramps? How should we deal with it?

The menstrual cramp can be avoided with pain killers but if it’s prolonged and unbearable, female folk should consult a doctor. Also if the periods are heavy and come with clots, usually big clots, then a doctor has to be consulted.

 

What are the most common menstrual problems faced by females?

Heavy periods, light periods, early periods, late periods etc. are some of the common problems. Early periods can be related to infections and sometimes can also happen due to hormonal disturbances. Late disturbance can happen due to PCOS and also due to hormonal disturbances.  One has to do regular physical exercises, eat a healthy and balanced diet.

 

Painful periods or endometriosis is common in women folk. What should women do in such 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. 

 

Infertility is the serious issue that most of the women are facing. What should they do? 

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 common conditions in young girls and women. What is it 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, the 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.

 

Talking about cysts, are all cysts 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. 

 

What will be your message or suggestion for women folk?

Every girl should understand that menstruation is the normal part of the female body. It is nothing to be ashamed of. One should lead a normal life during periods and in case the periods are interfering with normal life in the form of heavy or painful bleeding, then they should see a doctor. They should not think that it happens and every girl has to suffer. It’s not like that. Girls are not meant to suffer.