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DISEASES OF WOMEN

ABORTIONS

Abortions or Miscarriages are a frequent occurrence and in many cases is due to chromosomal anomalies in the foetus. Many times the foetus is abnormal and incapable of survival after birth. The chromosomes of the father and mother come together in thousands of combinations, resulting in a variety of offspring with different body types, features and attributes. Sometimes due to chance, the combining chromosomes produce a defective child, simply because of the science of probability. Downs syndrome, severe genetic and congenital defects in the heart, brain and other vital organs make life unviable. In such cases, the intelligence of the body decides to abort the baby rather than give it an impossible life. In many cases, this abortion is inevitable and cannot be prevented. Thus self-blame for inability to retain the foetus, guilt of overexertion, feelings of inferiority, tragedy and loss is unjustified. What is reassuring is that this pregnancy endorsed the structure and function of the reproductive tract as suitable for future pregnancies. So the couple should be grateful to the body’s wisdom and Nature which spared them as well as the to be born child, a lifetime of agony and suffering.

DELIVERY AND THE C SECTION ABORTIONS

In our civilised society, the pregnant woman is always advised rest, rest and rest. Spending all day indoors or in bed to prevent an imagined abortion will result in a fall of uterine tone, and may cause uterine inertia during labour resulting in difficult delivery. Therefore urban children take around 12 hours to be delivered, whereas village children are delivered in just a few hours. This is because the rural women labour all day for their bread and butter and develop a strong uterine tone, which facilitates easy delivery.
She is advised to eat well and gain weight. It is important to understand that the weight gain of pregnancy is due to many factors including rise in circulating blood volume, enlargement of uterus, breasts and other associated tissue and of course the enlarging foetus. Therefore eating compulsively to gain weight will result in gross obesity which will be difficult to get rid of after delivery.

INFERTILITY AND THE TEST TUBE BABY

The inability to conceive may simply be due to wrongly timed sexual encounter. The first day of menses is counted as day 1. The egg is released by the female sometime around the 14th day of the menstrual cycle. The sperm from the male live for 2 days. Therefore sexual intercourse from 12th day to the 16th day of the menstrual cycle will result in pregnancy. Any sexual intercourse on days other than that of egg release may not result in pregnancy, causing concerns of infertility.
True infertility may be due to male or female imperfections. In the male, it could be because of non-production of viable sperm by the testes. Sometimes the sperms are of low quality. The male semen has millions of spermatozoa, only one of which is required for conception. When the defect is in the male, what is needed is donor sperm. If the couple is willing to accept donor sperm from an unknown donor from a sperm bank, then all that is needed is Artificial Insemination of the sperm into the female vagina. However many couples may be advised IVF or Test tube baby even when the female is healthy and not at fault. This is an unjustified practice and needlessly drags the healthy woman to undergo the stress of IVF procedure.
In the female, infertility may be because of non-production of egg or blocked fallopian tubes. The egg is produced by the ovary and delivered through the fallopian tube to the uterus. One egg is all that is needed for conception. There are two ovaries. Every month alternate ovary produces the egg. So even if one ovary is malfunctioning, nature has given another ovary to compensate. The ovary has a lining of a finite number of immature eggs. Each month one egg matures and is transported to the uterus for fertilization.
Infertility in the female may also be because of blocked fallopian tubes due to previous infection and scarring. This blockage obliterates the lumen and prevents the egg from passing from the ovary to the uterus. IVF or In Vitro Fertilization is an expensive procedure where the fertilization takes place in the laboratory outside the female body.
IVF treatment is undertaken during many menstrual cycles, one of which may succeed. IVF involves the following stages:

Hyper-mature-izing the ovary with hormones to prepare multiple eggs for conception, instead of single egg every month.

Extraction of upto 20 eggs outside of the body

Fertilization of multiple eggs.

Instillation of fertilized egg into the uterus

Delivery of the baby

IVF is a procedure that works wonders for women whose tubes are genuinely blocked. IVF should not be routinely advised as the final and ultimate solution to all couples as the IVF procedure has many adverse effects. These are enumerated below.

Hormonal drug bombardment of the female results in weight gain, pigmentation and hormonal disturbances.

Hyper stimulation of the ovaries may cause multiple ovarian cysts.

The intense trauma and stress of undergoing the procedure may create marital discords.

Consumption of multiple eggs in each cycle may result in early depletion of the egg reserve, causing premature menopause.

Multiple cycles are required with repeated minor surgical procedures causing intense trauma to the mind and huge expenses which further traumatize the affording middle class.

VAGINAL BLEEDING AND HYSTERECTOMY

The normal physiology of the female reproductive tract is to produce an egg every month and if pregnancy has not resulted, shed it via the process of bleeding. So any malfunction of the tract results in excessive bleeding. Malfunctions everywhere in the body settle themselves, so why should we not trust the body to settle vaginal bleeding? These bleeding disorders are often hormonal dysfunctions which resolve spontaneously in a few months. During the vaginal bleeding, if some structural abnormality is found, then that takes the blame. Common structural abnormalities are uterine fibroids and ovarian cysts.

A large proportion of women have fibroids of the uterus. These are harmless muscular lumps and not cancerous i.e. they are benign. They seldom harm the patient and can be easily carried.

Ovarian cyst is another common disease. Most ovarian cysts are retention cysts which are nothing but unfertilized eggs lying in the ovary. Often these are misdiagnosed as pathological chocolate cysts and ovarian surgery is advised. If the woman has hormonal bleeding, then the innocent fibroids or ovarian cyst is held responsible. What can be done is to give time for the bleeding to resolve, by natures will or with medication, before opting out for invasive surgery. Laparoscopic surgery may be more dangerous as the surgeon has to operate via many tiny holes observing indirectly on a screen or scope, rather than by direct vision of the entire field.

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