Dr Krishnaveni Nayini

Treatments Obstetrics and Gynaecology

• Caesarean section/ vaginal birth
• Operative vaginal deliveries
• Complex perineal repairs
• Vaginal birth after caesarean (VBAC) service
• Colposcopy
• Laparoscopy for gynaecology patients
• Post-menopausal bleeding
• Infertility treatment
• Pregnancy and related problems
• Pregnancy scans
• Trans-vaginal scan

Post-menopausal bleeding

Menopause is usually diagnosed in women over the age of 45 years, who have not had a period for more than a year. Any bleeding or spotting from the vagina after this year is post-menopausal bleeding and needs to be checked by your healthcare provider.
Bleeding after menopause is usually a sign of a minor health problem but can sometimes be an early sign of a more serious disease.
If detected early any underlying condition small or big can be treated successfully.

What can it look like?

Post-menopausal bleeding can range from light spotting that is pinkish-gray or brown, or it can be a heavy flow like in regular periods. Most of the time there is no pain associated with this bleeding.

What can cause it?

  • The most common causes of post-menopausal bleeding can be:
  • Inflammation or thinning of the vaginal or womb lining
  • Non-cancerous polyps in the cervix or uterus
  • Endometrial hyperplasia (thickened womb lining)

In some cases, post-menopausal bleeding can also be caused by cancer, such as ovarian or womb cancer.
The treatment for post-menopausal bleeding varies as per the cause, and in any cause, early diagnosis is the best way to assure successful treatment outcomes.

Colposcopy

Colposcopy is a procedure done to examine your cervix, lower part of the womb, and the top portion of the vagina in detail. This procedure is done using a special instrument called a colposcope.

Why colposcopy?

You may be advised colposcopy if any abnormality is detected during cervical screening (abnormal Pap test result), and the cervix doesn’t appear as healthy as it should be. It may also be done to know the cause of problems such as unusual vaginal bleeding.

What to expect during colposcopy?

During the procedure an instrument is passed trans-vaginally and opened, via this a microscope with light is used to examine your cervix closely, the microscope doesn’t enter inside the body. If required biopsy from the tissues which appear unhealthy is also taken during the procedure.
The procedure is painless, though some discomfort or pressure may be felt in the vaginal area.

Infertility

Infertility is not being able to get pregnant despite having frequent, unprotected sex for at least a year. If you and your partner are struggling to have a baby, then you are not alone, infertility affects 15% couples worldwide.

What causes infertility?

Infertility can affect both the male and the female partner. Some causes of female infertility can be:
• Ovulation disorders- These can affect the release of eggs from the ovaries. Such disorders can be caused due to hormonal issues, eating disorders, tumours or unregulated excessive exercise.
• Uterine or cervical abnormalities, including endometriosis
• Abnormality or blockade of the fallopian tube (tube which carries the ovum to the uterus)
• Early menopause- At times ovaries may stop working and menstruation may stop before the woman hits 40, leading to infertility.

Other causes of infertility in a woman can include pelvic adhesions and cancers.