Latest news with #SapnaRaina
Mint
13-07-2025
- Health
- Mint
From pain to prevention, endometriosis treatment is finally offering relief
For decades, endometriosis has lurked in the blind spots of medical understanding. A chronic estrogen-dependent inflammatory condition, endometriosis often got dismissed as 'just bad periods." It affects over 190 million women worldwide, yet diagnosis is routinely delayed by 7 to 10 years, leaving countless lives disrupted by pain, misdiagnosis, and invisibility. 'Despite being as common as diabetes, it lacks a single definitive test and often takes more than seven years to diagnose," says Dr Anshumala Shukla Kulkarni, head of minimally invasive gynaecology and robotic surgery at Kokilaben Dhirubhai Ambani Hospital in Mumbai. But thanks to a growing body of research, cutting-edge diagnostics, and a systemic push for recognition, endometriosis is no longer being relegated to the margins of women's health. 'Endometriosis is an estrogen-dependent inflammatory condition where endometrial-like tissue grows outside the uterus, most commonly on the ovaries, fallopian tubes, peritoneum, and, in severe cases, the bowel and bladder," explains Dr Sapna Raina, senior consultant at Narayana Health City, Bengaluru. 'Yet despite its prevalence, the average diagnostic delay remains 7–10 years." That delay, she adds, is not just a medical failure but a cultural one: 'The hallmark symptom—chronic pelvic pain—is often dismissed as normal period pain, especially in adolescents and young women." The consequences? Women are frequently misdiagnosed with conditions like irritable bowel syndrome or urinary tract infections, while the root cause—endometriosis—goes untreated. Dr Smeet Patel, endometriosis specialist at Mayflower Women's Hospital in Ahmedabad, agrees that this delay is emblematic of deeper systemic failings. 'There's definitely a gap in medical education where endometriosis isn't highlighted in early training," he says. 'Bias has a significant play too—women's pain is normalized or trivialized, and hence it gets delayed investigation." A QUIET REVOLUTION IN DIAGNOSIS New research is challenging the necessity of invasive laparoscopies for diagnosis. Among the most promising innovations are mRNA-based blood and saliva tests, which can detect molecular changes invisible to conventional imaging. 'AI-powered MRI with 3D pelvic reconstruction" is also transforming the diagnostic process, Kulkarni notes. These tools allow for 'a full extent of the disease to be understood pre-operatively," giving surgeons the ability to plan interventions with surgical precision. Additionally, the Ultrasound-Based Endometriosis Staging System (UBESS) offers 'a real-time, less-invasive alternative to exploratory surgery," while specific biomarkers like interleukins may soon enable clinicians to diagnose the disease with a simple blood test. Even menstrual blood is being explored as a diagnostic tool. 'Menstrual blood analysis is being explored for its potential to detect endometrial cells, inflammatory markers, or altered gene expression patterns linked to the disease," says Raina. Patel sees huge promise in these developments—if paired with accessibility. 'The potential of making a diagnosis with menstrual blood is really thrilling," he says. 'It could turn early detection on its head by providing a non-invasive, easily obtained sample—particularly for patients from resource-deprived areas or those unwilling to undergo laparoscopy." GETTING TO THE ROOT OF IT Perhaps the most profound shift is not in the tools, but in the way science is beginning to understand the disease itself. 'Recent studies are also exploring how the gut microbiome, immune dysfunction, and endocrine disruptors contribute to the development and persistence of endometriosis," Kulkarni explains. That means looking beyond the uterus to the whole body to understand potential triggers: * Disrupted immune surveillance may allow endometrial-like tissue to implant and grow outside the uterus. * Microbiome imbalances, especially in the gut and reproductive tract, appear linked to disease severity. * Long-term exposure to environmental toxins like BPA and phthalates is under investigation for triggering hormonal imbalances that may contribute to disease onset. If these connections hold, preventive strategies could begin early—during adolescence or earlier. 'Some researchers now believe that endometriosis may begin in utero or during early adolescence," Kulkarni adds. 'If validated, this could unlock a window for preventive care." RETHINKING ENDOMETRIOSIS TREATMENT While laparoscopy and hormonal suppression remain standard, 'surgical excision of lesions offers long-term symptom relief and improved fertility in select cases," says Raina. But increasingly, the approach is shifting toward less aggressive and more personalized solutions. Among these are 'rectal wall shaving" and 'disc resection" for bowel-involved cases, which aim to minimize complications while preserving fertility. Laparoscopic microwave ablation, particularly for women with adenomyosis, 'targets abnormal tissue with precision, preserving the uterine wall and reducing post-op recovery time." Still experimental but promising are regenerative medicine and neuromodulation techniques, including stem-cell therapies and nerve-targeting treatments to manage chronic pain and promote tissue healing. INTEGRATIVE CARE GAINS GROUND Patients, often out of desperation, have long turned to complementary therapies. Now, science is starting to catch up. 'Dietary approaches focusing on reducing processed foods and increasing omega-3s and fiber show modest but meaningful benefits," notes Kulkarni. Likewise, pelvic floor physiotherapy has shown particular promise for patients with deep infiltrating endometriosis (a severe condition where endometrial tissue grows deep- almost 5mm – into the pelvic tissues). And while acupuncture and stress-reduction techniques remain under-researched, early trials are hopeful. 'These approaches, when integrated with medical management, can improve quality of life and reduce flare-ups." Patel agrees but cautions against over-reliance. 'Holistic approaches such as diet and yoga can provide adjunctive relief, but not to the detriment of systemic, evidence-based treatment," he says. 'Endometriosis is an intricate medical condition—not a lifestyle disease. The burden of care should not fall solely on the patient." If innovation is one half of the solution, systemic reform is the other. "This delay [in diagnosis] reflects systemic gaps in how women's pain is understood and managed," says Kulkarni. She calls for improved medical training: 'There's a need to better equip general practitioners and gynecologists to recognize endometriosis early, especially in adolescents who present with chronic pelvic pain." Also urgent is the establishment of standardized diagnostic protocols, ensuring that primary care physicians follow a tiered and structured approach rather than resorting to dismissal. Finally, public awareness is key. 'Campaigns aimed at normalizing conversations about menstrual pain and encouraging early medical help-seeking can help reduce stigma and improve early intervention." In many ways, endometriosis is a medical paradox: common, devastating, yet long ignored. But that tide is finally turning. 'Endometriosis research is finally gaining momentum with significant progress in early diagnosis, less invasive treatments, and deeper understanding of its origins," Kulkarni says. 'While there's no cure yet, science is moving from symptom management to disease modification—and potentially, prevention." Tanisha Saxena is a Delhi-based independent journalist. She writes stories that are on the intersection of art, culture and lifestyle.
Time of India
04-06-2025
- General
- Time of India
Genetics, poor lifestyle cause premature menopause in more women in Bengaluru: Doctors
Bengaluru: Did you know menopause is happening earlier for many women in Bengaluru, with 6 in 10 of them experiencing it before they reach 40? Doctors are seeing women as young as 38 going through menopause or its symptoms. Reason: A cocktail of modern-day stressors. Dr Rubina Shanawaz Z, senior consultant in uro-gynaecology and gynae-oncology at Fortis Hospital, told TOI, "Menopausal age has been gradually shifting over the decades, and it's influenced by a variety of factors. Genetics plays a significant role. If your mother or sister experienced menopause at 50, you're likely to follow a similar timeline. But it's not just heredity, it depends on your level of physical activity, lifestyle choices, medications, hormone use, etc. " She explained, "Women now have low egg reserves and experience hormonal imbalances much sooner. So while the average lifespan has increased to 75 or 80, the reproductive window is shortening. In earlier generations, probably 1 in 10 women would report early menopause or its symptoms. Today, that number is closer to 6 out of 10." Another major factor is early menarche when girls begin menstruating earlier than the historical average of 12 years. Sponsored Links Sponsored Links Promoted Links Promoted Links You May Like AC Installation & Repair from Certified Pros Search7 Learn More Undo Doctors now report cases of girls starting their periods as early as 10. "Every menstrual cycle depletes the egg reserve. Since a woman is born with a fixed number of eggs, this can result in menopause occurring earlier than expected," said Dr Sapna Raina, senior consultant, obstetrics and gynaecology at Narayana Health City. Dr Raina said south Asian women, including those in India, typically experience menopause earlier than those in western countries. Here, menopause is considered normal if it occurs after the age of 45. When it happens between 40 and 45, it is termed early menopause. Before 40, it is classified as premature menopause. "While genetics plays a role, if your mother or grandmother had early menopause, you might too. Other factors like cancer treatments, pelvic surgeries and lifestyle habits like smoking can also cause the ovaries to stop functioning earlier," she said. Early menopause leaves the body without the protective benefits of oestrogen for a longer period. Oestrogen plays a key role in maintaining bone density and cardiovascular health. Dr Priya SP Patil, consultant obstetrician and gynaecologist at Altius Hospital, said: "There is an increased risk of osteoporosis, heart disease, memory issues, mood disorders, anxiety and depression post menopause." She said some women are being diagnosed with POI as early as 30. "It means the ovaries have exhausted their egg reserves prematurely, leading to infertility and an end to natural menstruation." Fertility specialists are also seeing more women in their early 30s with hormone and egg reserve levels typical of those in their 40s. "Ideally, menopause should occur between the ages of 45 and 55," said Dr Varsha Samson Roy, consultant and head of embryology at Birla Fertility & IVF. "But today, we are seeing AMH (Anti-Müllerian Hormone) levels dropping at a much younger age, suggesting a shorter menstrual cycle in their life, which can also lead to early menopause." What can lead to it Genetics Early menarche Exposure to endocrine disruptors Lifestyle stressors Nutritional deficiencies Habits like smoking and alcohol
The Hindu
20-05-2025
- Health
- The Hindu
Early medical care for pelvic organ prolapse symptoms can improve women's quality of life, experts say
Pelvic organ prolapse (POP) is far more common in India than most realise. Some research studies have found that up to 21% of women may experience clinically relevant POP. While nulliparous prolapse (in women who haven't given birth) accounts for just 1.5–2% of genital prolapse cases, the incidence jumps to 5–8% in women who have had one or two children -- among the highest globally. Although literature reports that 50% of women are affected by POP in their lifetime, doctors say the real number may be closer to 70–80%, with most cases going unreported due to stigma or lack of awareness. According to the World Health Organization (WHO), POP occurs when one or more pelvic organs -- such as the bladder, rectum, or uterus -- descend from their normal positions into or through the vaginal canal, due to the weakening of the pelvic floor muscles and connective tissue. It is a condition that impacts the lives of thousands of Indian women, particularly in their postmenopausal years. Lack of awareness leading to late detection Though POP has been recorded as early as 2000 BC in ancient texts, it remains misunderstood and underdiagnosed, especially in India. Many women accept the symptoms as a natural part of aging or womanhood. Shame, silence, and cultural stigma often prevent them from seeking timely help. Only a small percentage of women undergo treatment, despite its major impact on quality of life. Medical experts say early detection and intervention can drastically reduce the physical, emotional, and social toll POP takes on women. While a large percentage of women experience some degree of prolapse, only a subset develop symptoms significant enough to seek treatment. Even then, many remain undiagnosed. Sapna Raina, senior consultant at Narayana Health City, Bengaluru, explains, 'Pelvic organ prolapse primarily happens because of the weakening of pelvic floor and gluteal muscles. Multiple vaginal deliveries, prolonged labor, use of forceps during childbirth, poor antenatal or postnatal care, chronic constipation or cough, menopause, lifting heavy weights, smoking, and obesity—all contribute to this weakening.' She emphasises that menopause plays a critical role due to the natural drop in estrogen, which compromises the strength and elasticity of pelvic tissues. She also notes that poor lifestyle practices and delayed care further worsen the condition. Importance of seeking care early POP often begins subtly. Early signs include urinary leakage when coughing or sneezing. As it progresses, women may experience a dragging sensation in the lower abdomen, difficulty urinating or passing stool, or a visible bulge at the vaginal opening. In advanced cases, symptoms can include repeated infections, foul-smelling discharge, chronic back pain, and significant discomfort while walking or sitting. Mannan Gupta, chairman and HOD of obstetrics and gynaecology at Elantis Healthcare, New Delhi, says, 'It's very common in older women who've had multiple normal vaginal deliveries. The uterus, rectum, and bladder can descend, and in severe cases, even protrude through the vaginal canal. Treatment at that stage often requires surgery.' He adds that awareness remains low, particularly among elderly women, many of whom endured childbirth in the 1980s and 1990s under limited medical supervision. These women now present in their later years with advanced POP. Jaishree Gajaraj, head of obstetrics and gynaecology at MGM Healthcare, Chennai,says, 'Many women live with this for years, thinking it's just a part of growing old. But those who undergo treatment --whether non-invasive or surgical --often feel like they've regained their life.' Non-surgical and surgical management Early diagnosis can prevent progression. Mild prolapse can be managed with pelvic floor physiotherapy, including Kegel exercises and strengthening of the core and gluteal muscles. Preventive care also includes addressing chronic constipation, avoiding heavy lifting, managing weight, and ensuring good antenatal/postnatal care. 'Regular exercise and timely medical attention are key,' says Dr. Raina. 'In the early stages, prolapse can often be corrected without surgery. 'However, when the condition advances, surgical intervention may be necessary. Dr. Gupta adds, 'Delaying care means patients may require surgery under general anesthesia, which is riskier for elderly women or those with co-morbidities.' Surgical options such as laparoscopic repairs or mesh implants are available for more severe cases. Dr. Gajaraj elaborates on the surgical process, 'When the uterus descends, it pulls the bladder in front and the rectum behind. Surgery typically involves removing the uterus, repositioning the bladder and rectum, and tightening the vaginal wall to restore pelvic support.' Post-surgery, most women report relief from symptoms such as urinary incontinence and pelvic discomfort. Many regain their mobility, independence, and confidence within a few weeks. Call for awareness, better programmes and timely action Despite POP's widespread impact, it remains absent from national health conversations. Dr. Gupta remarks, 'There are campaigns for conditions like anaemia and diabetes, but nothing specifically for pelvic organ prolapse.' He calls for awareness programmes, particularly in rural and semi-urban regions where symptoms are often normalised or ignored. Dr. Raina confirms that there are currently no dedicated government programmes for prolapse, though it may be loosely addressed under general maternal and reproductive health schemes. 'Honestly, we don't have standalone programs for this. Some degree of prolapse is seen in 70–80% of women, but symptomatic full-blown cases are still under 5%,' she says. Most women don't even know their suffering is due to a treatable condition,' says Dr. Gajaraj, emphasising the need to normalise conversations around pelvic health, while acknowledging initiatives like the Society of Vaginal Surgeons of India, where she was formerly the director, and stressing that both awareness and access to care must improve. Experts stress that POP should not be accepted as an inevitable consequence of childbirth or ageing. With better education, early detection, lifestyle changes, and appropriate medical interventions, women can reclaim not only their health, but also enjoy a better quality of life.
Time of India
16-05-2025
- Health
- Time of India
Karnataka sees 20% surge in C-section deliveries
Representational Image BENGALURU: More babies are entering the world under the surgeon's scalpel in Karnataka than ever before. In the past three years alone, the state recorded a 20% rise in C-section deliveries. Health and family welfare department data accessed by TOI showed that in 2024-25, out of 8.32 lakh institutional deliveries registered in the state, 3.88 lakh were C-section deliveries. Surprisingly, Bengaluru Urban alone contributes 20% of the total C-section deliveries recorded in 2024-25. This is not a sudden jump; Bengaluru Urban's C-section rate has been rising steadily, from 43.25% in 2022-23 to 44.26% in 2023-24, and now touching new highs. Out of 1.46 lakh deliveries registered in the district this year, 72,014 were C-sections, almost every second birth. Other districts like Belagavi(35,903), Tumakuru (18,999), Kalaburagi (17,202), and Vijayapura (16,440) are also seeing higher-than-average surgical births, while Chamarajanagar and Kodagu stand out with significantly lower rates, reporting just 4,447 and 1,948 C-sections respectively since April 2024. Dr Savitha C, Medical Superintendent at Vani Vilas Hospital, shed light on the rising C-section trend. by Taboola by Taboola Sponsored Links Sponsored Links Promoted Links Promoted Links You May Like Grebenstein: GEERS sucht 700 Testhörer für Hörgeräte ohne Zuzahlung GEERS Undo 'There's a clear surge in high-risk pregnancies today, often driven by increasing lifestyle disorders such as diabetes, hypertension, and obesity. Infertility treatments are also on the rise, not just due to medical conditions like PCOS, but because many women now delay childbirth or prefer assisted reproduction, often due to fear of labour or a conscious decision to have only one child,' she explained. Medical advancements, she noted, made it possible for even women with serious cardiac issues to carry pregnancies, something unthinkable a few decades ago. Still, she cautioned: 'Normal delivery, when possible, is always better. A woman who delivers naturally is up and walking within hours, while a C-section is major surgery that carries risks of infection, delayed recovery, and, rarely, mortality.' Dr Sapna Raina, Senior Consultant at Narayana Health City , emphasised early intervention: 'To truly reduce C-section rates, we must focus on first-time mothers. A primary cesarean often leads to repeat surgeries in future pregnancies because a scarred uterus carries rupture risks. Many women today, especially in cities like Bengaluru, undergo IVF or conceive later in life, factors that raise the likelihood of complications. Add to that the emotional weight of a 'precious pregnancy' in couples who want only one child, and C-sections become the preferred choice in even borderline cases. ' Another often-overlooked factor, says Dr Priya S P Patil , Consultant at Altius Hospital, is cultural. 'Yes, we've seen a rise in elective C-sections driven by requests to deliver at an 'auspicious time.' Many families want their child born at a specific hour for spiritual or astrological reasons. That's increasingly common now,' she highlighted. She added that legal concerns also weigh heavily on doctors. 'In prolonged labour, where outcomes can't always be predicted, physicians often choose surgery over risk to avoid litigation. When you combine all this, repeat C-sections, older mothers, lifestyle diseases, elective preferences, and fear of lawsuits, the numbers make sense. But we must remember, cesarean is a life-saving procedure when needed. When not, it's still a major operation with long-term consequences like scarring, infertility, and difficult recoveries. '
