Dr Suman Bijlani, Gynaecologist, Sonologist, Infertility Specialist, Obstetrician and Laparoscopic Surgeon, Mumbai.

Welcome, ladies, to the blog of Gyneguide, India’s only personalised gynaecological online consultation and live chat website!

This is a forum by women for women to exchange ideas and experiences about reproductive health and being a woman in today’s world.  My wish for you is “To be healthy and confident.” So feel free to express, share, learn, grow, and love.

Love you.

Dr Suman Bijlani,
Gyneguide – Helping women live better

PAP Smear and Cervical Cancer Vaccine

Cervical cancer (cancer of the lowermost part of the uterus) is a leading cause of deaths in the Indian subcontinent and it is the number one cause of cancer-related deaths in India.

Globally, each year, 500,000 women are diagnosed with cervical cancer and 270,000 women die from it. In India itself, each year, 1,32,000 women are diagnosed with cervical cancer and 74,000 women die from it!

The irony is that the western world, which has fewer cases, is far more active in taking preventive steps like early screening (PAP Smears) and vaccination, while the developing world which as got most of the cases of cervical cancer, is still struggling to educate its masses to undergo screening and vaccination.

What is screening?

     As we all know, most cancers do not cause symptoms until it is too late. Hence, screening for cancer is the single most important step in cancer prevention. Screening is looking for cancer before a person has any symptoms. This can help detect cancer at an early stage, when it may be curable. By the time symptoms appear, cancer is likely to have begun to spread.

Cervical cancer usually develops slowly over time (over many years). Before cancer appears, the cells of the cervix go through changes known as dysplasia, which can be detected by screening.

What is the PAP test?

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Irregular periods

Most of us experience irregular periods at some point of time in our life… And we do so HATE to have to visit a gynaecologist.

Well, friends...

If it is your first time, you may wait and watch. A one-off thing can be due to stress or some lifestyle change or just unexplained. If the problem persists, it is time to see your gynaecologist.

If periods happen more frequently (polymenorrhoea), it is usually due to hormonal imbalance (anovulation)

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Osteoporosis (Weak bones)



Osteoporosis is a condition characterised by weak bones resulting from decreased mineralisation and reduced bone mass leading to an increased risk of fractures.

Osteoporosis is very common after menopause, when it is called post menopausal osteoporosis. This is a very specific condition where rapid bone loss occurs due to withdrawal of the hormone estrogen.

Bone mass is not constant. Bone is a dynamic tissue whose mass is affected by the process of bone resorption and new bone formation. At any given point of time, we are constantly losing bone by resorption as well as forming new bone. This is known as remodelling of bone.

Estrogen hormone prevents bone loss and facilitates new bone formation.

Factors which accelerate bone loss include:

  • Increasing Age
  • Female Gender
  • Sedentary lifestyle
  • Diet poor in Vitamin D, Calcium and other minerals
  • Excessive caffeine or alcohol intake and smoking
  • Steroid intake over prolonged period
  • Hyperthyroidism
  • Any chronic debilitating illness like tuberculosis

Osteoporosis is a silent disease and may persist for years without causing any symptoms.

It affects the wrists, hips, spine and ribs.

It may cause bone pains and loss of height in the long run with a hunch back in extreme cases.

The commonest and the most dangerous complication is fractures. Hip fractures are particularly common among the elderly and often occur with the slightest of falls and are associated with high mortality and adversely affect the quality of life.

It is particularly important to pick up this condition in its early stages so that treatment is more effective and complications may be prevented.



For personal consultation with Dr Suman, please click here.

For further clarification/ free online consultation, please click here.

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Menopause is the permanent cessation of menses in a woman’s life. Typically it is diagnosed after 12 months of amenorrhoea ( no menses ). It also marks the end of her fertlility (childbearing capabilities).

The hormone estrogen is no longer produced by the ovary (only very small amounts are produced from other sources) and this leads to a host of other changes in the body.

A woman may experience a lot of physical and mental changes during this transition of life. Although a lot of women have mild symptoms and they brush it off as something inevitable and natural, many suffer from distressing symptoms (like hot flashes or painful intercourse).

A large majority can make do with counselling and lifestyle modification while some women need to take treatment for emotional and sexual difficulties as well as urinary complaints (frequency and incontinence).

With proper care, most women can prevent long term complications like osteoporosis (weak bones) and atherosclerosis (heart disease and stroke).

It would make sense for most women to undergo cancer screening for breast and cervical cancer at this stage.

For a personal consultation with Dr Suman, please click here.

For further clarification/ free online consultation, please click here.

Gyneguide – helping women live better!

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Urinary leak

Urinary incontinence means involuntary leakage of urine. In other words, it is inability to hold back urine under certain conditions.

This problem affects millions of women all over the world. Almost 20 to 30% of young women and 50% of the elderly suffer from this condition though many do not report it even to their doctors due to embarrassment. Some are forced to use pads throughout the day while others learn with experience, to empty their bladder frequently or squeeze their pelvic muscles every time they cough or sneeze, to prevent that leak!

When a woman often leaks urine at any time, any place, she gradually lose her confidence to go out or socialise. In severe cases, she may end up depressed and become a social recluse.

How does our system control urine?

The urinary bladder is the bag which stores urine. It is made up of muscle fibres known as the ‘detrusor’ muscle, the contraction of which pushes urine out of the bladder. Another muscle, the ‘internal urinary sphincter’ surrounds the outflow passage from the bladder and helps to close the urinary passage and hold back urine.

When the volume of urine reaches a certain amount in the bladder and the person finds a suitable place to relieve herself, the detrusor contracts, the sphincter relaxes and urine flows freely.

Why do some women lose urine control?

Women are much more likely to develop incontinence because excessive stretching during pregnancy and childbirth can result in weakening of pelvic muscles which hold back urine. After menopause the pelvic floor can weaken further worsening the condition. Apart from this, weakness of nerves or muscles due to aging or uncontrolled diabetes can contribute to loss of urinary control in both sexes.

Incontinence does not happen to all women with aging and women suffering from it should seek treatment.

Commonly, incontinence in women can be of the following types:

   Stress incontinence means loss of urine whenever the pressure inside the abdomen increases such as while sneezing, coughing, lifting weights or laughing aloud. This is usually the direct result of weakness of the pelvic floor and is common after childbirth and menopause.

   Urge incontinence means that when the person gets the urge to pass urine, she senses urgency and leaks small amounts of urine even before she can reach the toilet. It is often accompanied by frequency (having to pass frequently).

   It is usually the result of an ‘overactive detrusor muscle’ caused by urine infection or irritation, or nerve damage due to conditions like multiple sclerosis, spinal cord injury or Alzheimer’s disease. It is common among women in the fourth decade onward.

   Mixed incontinence is the presence of both stress and urge incontinence. Thus, she may leak urine in response to cough, sneeze, and may also not be able to hold urine till she reaches the toilet. This is the most common type of incontinence among women.

Urinary leaks may often be accompanied by weakness of pelvic floor muscles leading to prolapse or ‘something coming out from the vagina’.


   Please understand that the diagnosis of the type of incontinence is critical as treatment depends entirely on the type of incontinence. Your doctor may tell you to maintain a ‘urinary diary’ in which you would need to write down day-to-day details of your urinary habits and leak episodes. Besides, routine tests and a sonography of the urinary tract, you may need to undergo cystoscopy (visualisation of the inner lining of the bladder through a telescope).

   Urodynamic study is a special test to measure pressures within the bladder and urethra and it helps to determine the type of incontinence. This test is done in specialised hospitals and clinics and may take many hours to perform.


In general, treatment for stress incontinence is surgery to support the pelvic floor muscles, while treatment for urge incontinence is medication to relax the detrusor muscle. However, treatment has to be individualised as each case is unique and a combination of medical and surgical treatment is often needed.

Pelvic floor exercises (Kegel’s) help to strengthen the pelvic muscles and offer relief to many women with mixed and stress incontinence of the mild variety, but are largely ineffective in severe cases.

Many new simpler surgeries (slings, tapes, injections, laparoscopic and cystoscopic suspension) are available now which entail minimal anaesthesia, low risk and good results too. If you have prolapse, we would need to surgically correct that as well at the same sitting.

It is very important that you discuss with your doctor the various options and have a clear idea of what to expect from treatment, especially surgery. Treatment should take into account your needs and preferences. Surgery for incontinence may not always be completely successful and may cause difficulty in passing urine in the immediate post-operative period. Medical treatment may need to be taken over prolonged periods.

For personal consultation with Dr Suman, click here. 

For further clarification/ free online consultation, click here.

Gyneguide - helping women live better.


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