From irregular periods and infections to fibroids and ovarian cysts, every woman faces one or another gynaecological problem during her lifetime. “In the UAE, most often we see polycystic ovaries, menstrual irregularities and endometriosis,” says Dr Chitra Gopalakrishnan, Specialist Obstetrics and Laparoscopic Gynaecology at Aster Hospital, Al Qusais. “These could be because of obesity, lack of exercise, and a tight work schedule. Women seem to be more stressed, which leads to changes in lifestyle and food habits resulting in obesity and hormonal changes.”
Here we take a look at the common gynaecological disorders women in the UAE face.
Polycystic ovarian disease is a hormonal disorder that interferes with the release of eggs from the ovary. Marked by enlarged ovaries, high levels of androgens or male hormones, menstrual irregularities, excess hair on face and body, and more, it is the most common cause of infertility in women. “About 15 years back, the incidence rate of polycystic ovarian disease, or PCOD, was only 10 per cent, but it has now increased to around 50-60 per cent,” explains Dr Fathima Safa, Specialist Obstetrics and Gynaecology at Aster Hospital, Al Qusais.
She attributes this rise to change in lifestyle, increased consumption of junk food as well as use of plastics and cosmetics resulting in exposure to endocrine disrupters like phthalates and other chemicals. “I advise my patients to adopt a healthy diet, regular exercise, restrict use of personal products and choose products more natural in origin,” adds Dr Safa. If lifestyle modifications don’t help, menstrual irregularities are dealt with hormonal treatments while infertility issues are solved using reproductive technologies. “It is also important to give an ideal intrauterine environment to the developing foetuses to prevent the incidence of PCOD in them.”
Menstrual irregularities cover a wide range of conditions caused by pathological as well as lifestyle factors. It’s considered abnormal if a period occurs in less than 21 days or has a gap of more than 35 days. If you have missed three or more periods in a row, it definitely warrants a gynaec consultation. Any period that lasts longer than seven days, one that is accompanied by severe pain, nausea or vomiting, flow heavier or lighter than usual and bleeding or spotting between periods all need to be looked at by a gynaecologist to ensure there are no underlying medical problems such as fibroids, endometriosis or polycystic ovarian disease.
Most ovarian cysts - fluid-filled sacs in an ovary or on its surface - are harmless and disappear without any treatment. But some, especially ruptured or large ones, cause severe abdominal or pelvic pain with fever or vomiting. The chances of developing an ovarian cyst is high if there are hormonal problems or endometriosis. Consult a doctor if unusual menstrual symptoms continue for more than a couple of cycles.
About 40-80 per cent of women are estimated to have fibroids, which are benign muscle and connective tissue growths on the uterine wall. They grow in clusters or as a single nodule and range from 1mm to 20cm in size. Most women don't realise they have fibroids mainly because the small ones don't cause any symptoms. But depending on the size, number and their location, symptoms vary, which include heavy bleeding during period, lower back pain, frequent urination and pain during intercourse. Treatment includes medication and surgery.
This is another common gynaecolgical disorder where the tissue lining the uterus – endometrium - grows outside, usually around and beneath the ovaries and fallopian tubes. As the uterus lining thickens and breaks down during a cycle, the endometrium outside the uterus also builds and breaks down causing small amounts of bleeding, leading to pain, swelling and scarring.
“Endometriosis is seen in around 20-30 per cent of women,” explains Dr Safa, “and the incidence varies according to ethnicity.” It is more common among Asians.
Adolescents with painful periods and women experiencing painful intercourse should get themselves evaluated, she adds. “With the advent of minimally invasive surgical techniques such as laparoscopy and new medications, effective treatment is available.”
These infections are quite common in the UAE due to the hot and humid climate. They are caused when there is an imbalance in the bacteria and yeast that normally live in the vagina. For effective treatment, an accurate diagnosis as to whether a bacteria, yeast or virus has caused the infection is necessary. Book an appointment with a gynaecologist if you have vaginal discharge, irritation, pain or itching. Sometimes, chemicals in soaps and clothing can also cause irritation. Experts advise following good personal hygiene and drinking enough water to prevent infection. If you are prone to yeast infection, reduce the amount of sugar in your diet.
Urinary tract infections
Caused by bacteria, urinary tract infections are more common in women because microorganisms can easily reach the bladder through the shorter urethra. Symptoms include frequent urge to urinate, burning sensation while urinating, and cloudy urine. If left untreated, UTIs can cause serious complications including recurrent infections, kidney infection and premature delivery.
“Every year 108 women are diagnosed with cervical cancer in the UAE and 56 die from the disease,” explains Dr Sejal Devendra Surti, Specialist Obstetrics and Laparoscopic Gynaecology at Aster Hospital, Mankhool. She believes there is a need to create more awareness. “The best way to prevent cervical cancer is to get vaccination at an early age against HPV, which is the precursor to cervical cancer, and go for regular PAP smear and HPV tests. Pain is the last symptom of cancer, so conduct regular screenings to catch it early.”
Experts at Aster have a combined experience of more than 100 years and are specialised in treating gynaecological disorders including cancer, offering an integrated approach to diagnosis and management. “We work along with our state-of-the-art oncology department to ensure that no one is left untreated who indicate any symptoms of cancer.”