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Abnormal Uterine Bleeding

The normal length of the menstrual cycle is typically between 24 days -38 days. A normal menstrual period generally lasts upto 8 days. Bleeding in any of the subsequent situations is considered unusual uterine bleeding

  •   Bleeding between the periods
  •   Bleeding after sex
  •   Heavy bleeding during the period
  •   Irregular menstrual cycles
  •   Irregular periods in which the cycle length varies by more than 7-9 days
  •  Bleeding after menopause
Causes of abnormal uterine bleeding
  •   Ovulation problems
  •   Fibroids and polyps
  •   Bleeding disorders
  •   Cancers – Endometrial cancer
  •   others
Diagnosis and treatment

Based on the symptoms and age gynaecologist performs examination and tests including ultrasound scan, hysteroscopy, endometrial biopsy, sonohysterography, magnetic resonance imaging and computed tomography to diagnose the causes of abnormal uterine bleeding Medications including hormone growth control pills, gonadotropin releasing hormones, tranexamic acid and non-steroidal inflammatory drugs help treat heavy or irregular menstrual bleeding

Uterine fibroids are noncancerous growth of the uterus that frequently appears through the childbearing years. Many women often do not have any associated symptoms. In those that do, symptoms are influenced by the location, size and number of fibroids. In women who present symptoms, the most common symptoms of uterine fibroids include:

  •    Heavy menstrual bleeding
  •    Menstrual periods lasting more than a week
  •    Pelvic pressure or pain
  •    Frequent urination
  •    Difficulty emptying the bladder
  •    Constipation
  •    Backache or leg pains
Causes of fibroid uterus
  •    Genetic changes
  •    Hormonal changes
  •    Growth factors
  •    Medications such as Gonadotropin-releasing hormone (GnRH) agonists
  •    Intrauterine device (IUD)
  •    Laparoscopic myomectomy
  •    Hysterectomy
  •    Endometrial ablation
  •    Uterine artery embolization

Endometriosis is a painful disorder in which tissue that normally lines the inside of your uterus the endometrium grows outside the uterus. Endometriosis mainly involves the ovaries, fallopian tubes and the tissue lining your pelvis. Rarely, it may spread beyond the pelvic organs

Causes of endometriosis
  •    Retrograde menstruation
  •    Transformation of peritoneal cells
  •    Embryonic cell transformation
  •    Surgical scar implantation
  •    Endometrial cells transport
  •    Immune system disorder
Common signs and symptoms of endometriosis may include:
  •    Dysmenorrhea
  •    Pelvic, lower back and abdominal pain
  •    Pain during or after intercourse
  •    Pain with bowel movements or urination
  •    Excessive bleeding during periods
  •    Infertility
  •    Fatigue, diarrhea, constipation, bloating or nausea, particularly during menstrual periods.

Adenomyosis occurs when the tissue that generally lines the uterus grows into the muscular wall of the uterus.


The causes of adenomyosis remain largely unknown, however many theories have been postulated including

  •    Invasive tissue growth
  •    Developmental origins
  •    Uterine inflammation related to childbirth
  •    Stem cell origins
  •    Endometrial cells transport
  •    Immune system disorder
  •    Heavy or prolonged menstrual bleeding
  •    Severe cramping during menstruation (dysmenorrhea)
  •    Chronic pelvic pain
The doctor suspects adenomyosis based on the
  •    Signs and symptoms
  •    Pelvic examination that reveals an enlarged, tender uterus
  •    Ultrasound imaging of the uterus
  •    Magnetic resonance imaging (MRI) of the uterus
Treatment options for adenomyosis include:
  •    Anti-inflammatory drugs
  •    Hormonal medications
  •    Hysterectomy
Ovarian cysts

Ovarian cysts are fluid filled sacs within the ovary or on its surface. These ovarian cysts are caused due to


The causes of adenomyosis remain largely unknown, however many theories have been postulated including

  •    follicular cyst
  •    corpus luteum
  •    dermoid cyst
  •    cystadenomas
  •    endometriomas
Symptoms of ovarian cyst include
  •    pelvic pain
  •    fullness of the abdomen
  •    bloating
Diagnostic test performed for ovarian cysts
  •    Pregnancy tests
  •    Pelvic ultrasound
  •    laparoscopy
  •    CA 125 blood test
Treatment options for adenomyosis include:
  •    Anti-inflammatory drugs
  •    Hormonal medications
  •    Hysterectomy

Amenorrhea is the absence of menstruation which can be one or more missed menstrual periods.

Causes of amenorrhea include
  •    Medications
  •    lifestyle factors
  •    hormonal imbalances
  •    structural imbalance of the ovary
Symptoms of amenorrhea;

    Apart from the main sign i.e. absence of menstruation the individual also experiences

  •    Hair loss
  •    Headache
  •    vision changes
  •    facial hair
  •    pelvic pain
Diagnostic tests for amenorrhea includes
  •    thyroid function test
  •    ovary function test
  •    prolactin test
  •    imaging tests including ultrasound, computerized tomography and magnetic resonance imaging

Treatment varies according to the underlying cause of amenorrhea. In some cases, contraceptive pills or other hormone therapies can help normalize the menstrual cycles. Amenorrhea caused by thyroid or pituitary disorders may be managed using medications. In case of a tumor or structural blockage causing this problem, surgery may be necessary.

Cervical dysplasia

Cervical dysplasia is a precancerous condition involving atypical cell growth on the surface lining of the cervix or endocervical canal, the opening present between the uterus and the vagina

  •    Human papillovirus infection (HPV 16, 18)
  •    Smoking
  •    Immunosuppressive drugs
  •    HIV infection

Appropriate tests to detect the presence of cervical dysplasia

  •    Pap smear
  •    Endocervical curettage
  •    Cone biopsy or loop electrosurgical excision procedure
  •    HPV DNA test

Treatment for cervical dysplasia includes two of the above mentioned diagnostic procedures used for diagnosis i.e. cone biopsy and loop electrosurgical excision procedure

Other treatments include
  •    Cryosurgery
  •    Electrocauterization
  •    Laser surgery
Chronic pelvic pain

Chronic pelvic a pain is pain in the area below the umbilicus region that lasts for a period of six months or longer.

  •    Endometriosis
  •    Musculoskeletal problems
  •    Chronic pelvic inflammatory diseases
  •    Fibroids
  •    Irritable bowel syndrome
  •    Interstitial cystitis
  •    Pelvic congestion syndrome

Usually, chronic pelvic pain is described in one or more of the following ways

  •    Severe pain
  •    Intermittent in nature
  •    Dull aching type
In addition the patient experiences
  •    Pain during the intercourse
  •    Pain during bowel movement or urination
  •    Pain when you sit down for prolonged periods of time
  •    Pelvic examination
  •    Ultrasound tests
  •    Imaging tests including computerized tomography, magnetic resonance imaging
  •    Laparoscopy
  •    Medications including analgesics, antibiotics and antidepressants
  •    Physical therapy
  •    Uterine Stimulation
  •    Trigger point injections
  •    Psychotherapy
  •    Hysterectomy
Sexually transmitted infections

Sexually transmitted diseases are infections that pass from one person to another during sexual contact

Most common types
  •    Human papillomavirus infection: An infection that causes warts in different regions of the body depending on the particular strain causing it
  •    Genital herpes: A frequent sexually transmitted infection manifested as genital pain and sores
  •    Chlamydia: It's a common, sexually transmitted infection that may not cause symptoms
  •    Gonorrhea: A sexually transmitted bacterial infection that leads to infertility if it is not adequately untreated.
  •    HIV/AIDS: HIV causes AIDS and interferes with body's ability to fight infections
  •    Syphilis: A bacterial infection frequently spread by sexual contact starting as an painless sore.

Birth control, also well-known as contraception and fertility control, is a technique or device used to prevent pregnancy

The most effective methods of birth control are
  •    Tubal ligation in females
  •    Intrauterine devices (IUDs)
  •    Birth control pills
  •    Sterilization by means of vasectomy in males
Less effective methods include physical barriers such as
  •    Condoms
  •    Diaphragms
  •    Birth control sponges
  •    Fertility awareness methods
Premenstrual syndrome

Premenstrual syndrome is a group of complex symptoms (including emotional stress and fluid retention) experienced by some women in the days immediately prior to the menstruation.


The causes of adenomyosis remain largely unknown, however many theories have been postulated including

  •    Hormonal changes
  •    Altering serotonin levels
  •    Depression
  •    Abdominal pain and bloating
  •    Food cravings, especially for sweets
  •    Constipation
  •    Diarrhea
  •    Headaches
  •    Sensitivity to light or sound
  •    Fatigue, irritability and changes in sleep patterns
  •    Anxiety
  •    Depression

Premenstrual syndrome is a condition that is largely self-diagnosed. The practitioner helps diagnose the condition if the individual has any of the symptoms mentioned above.

  •    Serotonin reuptake inhibitors
  •    Other psychoactive drugs
  •    Hormonal interventions

Breast Diseases

There are many different types of breast diseases. These include infections, cysts, and swellings associated with or without pain.

List of breast diseases
  •    Breast cancer
  •    Fibroadenoma
  •    Mastitis
  •    Ductal carcinoma in situ
  •    Intraductal papilloma
  •    Duct ectasia of breast
  •    Gynecomastia
  •    Paget’s disease of the breast
  •    Lobular carcinoma
  •    Subareolar abscess
Adolescent Clinics

Adolescent medicine is a therapeutic subspecialty that primarily focuses on the care of Individuals who are in the adolescent period of development
The adolescent clinics provide services on

  •    Sexually transmitted diseases
  •    Birth control
  •    Substance abuse
  •    Menstrual disorders
  •    Eating disorders anorexia nervosa and bulimia nervosa
  •    Anxiety disorders
  •    Delayed puberty
Menopause clinic & Hormone Replacement Therapy

Menopause requires no medical therapy. Menopause clinics help manage women manage symptoms of menopause. Most of these issues that women encounter are simple which can be managed with the right advice. Treatments may include hormonal therapy, low dose antidepressants, gabapentin, clonidine and medications to prevent or treat osteoporosis Hormone replacement therapy Hormone replacement therapy (HRT) is a therapeutic regimen that helps relieve symptoms of menopause. Uses of hormone replacement therapy During menopause there is a decrease in the level of oestrogen accounting for symptoms including vaginal dryness, hot flashes and other symptoms of menopause. Hormonal replacement therapy helps relieve most of the menopausal symptoms, such as:

  •    Hot flushes
  •    Night sweats
  •    Mood swings
  •    Vaginal dryness
Dr. Sumina Reddy | Gynecology Services in Banjara Hills, Hyderabad. The Best Gynecology Clinic in hyderabad, Hyderabad.