What is the guarantee that cord blood stem cell banking saves life?
A: While there is no guarantee when it comes to saving a life, cord blood stem cell banking has been quite successful. There have been over 6000 transplants worldwide and 20 in India. Trials are also currently being performed for expanded uses of stem cells.

How long does it take to conceive?
A: Most couples will conceive within two years if they do not use contraception and have regular (every 2 or 3 days) sex. After 35 years of age, your chances of conceiving fall rapidly. At 38, you may fail to conceive even after three years of regular unprotected sex. This is why it is so important to go for infertility treatment sooner rather than later if you are over 30 years of age and have trouble conceiving.

What are the causes of infertility?
A: There are many causes of infertility. Some of the most common ones are listed below.

When should one start taking infertility treatment?
A: Infertility treatment should be started within one year of trial for women below 30 years of age and after 6 months for women more than 30 years of age.

What is IVF? And what is the guarantee that one will conceive with IVF?
A: IVF is in-vitro fertilization, what is called commonly as a test tube baby. IVF is the uniting of egg and sperm in vitro (in the lab). Later, the embryos thus formed are transferred from the lab into the uterus through the cervix and pregnancy is allowed to begin. Most success rates are 35 - 60% depending on individual patient.

What does IVF cost?
A: INR 75000/- for the first cycle
INR 45000/- for second cycle inclusive of all medicines & injections

Why do women get breast cancer?
A: Breast cancer occurs because of a number of reasons that could be genetic, lifestyle related or other gynecological reasons as well.

Is every lump in the breast, cancer?
A: Every lump in the breast is not cancer. There are a number of conditions which are non- cancerous, like for example fibroadenoma, a cyst, or an abscess. Certain signs of and symptoms of breast cancer are:
1) Lump
2) Dimpling of the skin over the breast
3) Change in the skin color
4) Blood stained nipple discharge
5) Change in the appearance of the nipple

How can one check for cancer in the breasts?
A: Follow these thumb rules for early diagnosis of breast cancer if any.
BSE: Start at 20 years and then onwards, monthly.
Mammography: Start at 35 years, then do it every 2-3 years till 40 years
Clinical Examination: Start at 40 years, then do it every 2-3 years till 60 and yearly after that till 69 years.

What is mammography? Does it hurt? What does it cost?
A: Mammography is an X Ray of the breast using low dose radiation. The breast is compressed between two plates and an X ray is taken. It may cause mild to moderate discomfort depending on individual tolerance. This is a quick, non invasive and efficient screening method. It takes only 20 minutes and can save your life. Before going for a mammography, avoid powder on your body near breasts as it may look like calcifications in the breast. Also, avoid deodorants and anti-perspirants, as they may fog the film.

Why should I have a mammography done?
A: Your breast may look and feel normal, but there could be cancer growing inside. Mammography is the most reliable method for early detection of breast cancer.

What other ways can one use to detect cancer?
A: Ultrasound. This is needed:
1. As a complement to mammography in women < 30 years of age
2. To distinguish between a benign cyst and a solid mass found on     mammography
3. If there is a clinically palpable mass that is not seen in a mammogram.

Do I have to lose my breast if I have breast cancer?
A: You don’t have to lose your breast if you have breast cancer. If diagnosed early, breast cancer can be treated effectively.

How can I prevent breast cancer?
A: Ginger, green tea, soya and its products seem to have protective effects against breast cancer. Alongwith these, diet and weight control are important factors. Regular screening remains the most important tool.

Breast cancer screening at O & P
A: You can get a mammography done at Oyster & Pearl. It costs about INR 650/-, Digital mammography costs INR 800-/. The state of the art Senograph DMR + here, allows better diagnosis. Because of its unique MaxiRay mammography tube, it is safe to use with exceptional image clarity.

What are the signs and symptoms of PMS?
A: There are some 150 symptoms associated with PMS that include breast tenderness, water retention with accompanying weight gain, changes in bowel habits, outbreaks of acne, food cravings, fatigue, aching muscles and joints, irritability, aggression, withdrawal, mood swings, and an inability to concentrate or think clearly.

How is PMS Diagnosed?
A: There is no laboratory test to verify the existence of PMS in a woman. The best way to do it is to maintain a record of the symptoms on a calendar for atleast two menstrual cycles. A number of standardized instruments have been developed to describe PMS, including the Calendar of Premenstrual syndrome Experiences (COPE), the Prospective Record of the Impact and Severity of Menstruation (PRISM), and the Visual Analogue Scales (VAS).

How is PMS treated?
A: PMS treatments usually emphasize on diet or lifestyle changes, and other supportive therapy like evaluation, reassurance, and informational counseling. Medical interventions are primarily hormonal interventions and use of selective serotonin reuptake inhibitors (SSRIs).

What actually happens during menopause?
A: Menopause is a part of the natural reproductive cycle. It is not a disease or a disorder. Menopause starts as the ovaries begin to fail naturally, which means they are not able to produce an egg or ovum every month. It also means there is an interruption in the production hormones. This is actually what leads to the sometimes erratic and long process of shutting down of the whole reproductive system.

At what age does menopause occur?
A: In Western countries, the average age of menopause is 51 years, whereas the normal age is anywhere between 45 and 55 years. There could be an exception in some cases where the last period comes between 55 to 60; this is known as late menopause. In about 1% of women, there could be an early menopause, where the last period occurs between 40 and 45 years of age. Usually, early menopause occurs due to several factors like autoimmune disorders, thyroid disease, diabetes, chemotherapy, and radiotherapy. Studies point out that in the 21st century menopause comes earlier than before, sometimes as early as 38 years.

How do I know that my menopause has started?
A: The effects of menopause can show on almost every aspect of a woman's body and life, from brain to skin. This is mainly a result of the body responding to the rapidly changing levels of natural hormones. The most common effects of the onset of menopause are lack of energy, hot flashes, night sweats and palpitations, poor sleep, psychological effects such as depression, anxiety, irritability, mood swings, memory problems and lack of concentration, vaginal dryness and urgency of urination, muscle pain, back pain, osteoporosis, formication (a sensation like pins and needles) and decreased libido.

I have heard Hormone Replacement Therapy is good in treating menopause?
A: If your symptoms are disruptive, that is if they interfere in your normal course of life to a large extent, your doctor may suggest Hormone Replacement Therapy (HRT). However, it will do well to bear in mind that all hormone replacement therapies in all probability, do carry some health risks, including high blood pressure, blood clots, and increased risks of breast and uterine cancers. It is therefore advisable for you and your doctor to carefully review your case, your complaints and the relative risk involved before going in for HT/HRT.

How do I handle the after effects of menopause?
A: The best way to handle menopause is to understand and know what menopause could bring with it. Many women arrive at their menopause years without knowing anything about what to expect, thus making things difficult to accept. Menopausal effects can be treated in a number of ways with medications to relieve symptoms like hot flashes, dryness, high blood pressure, depression. It would be advisable to go for alternative therapies like yoga and natural medicines, but of course not without your doctor’s advice. Individual counseling or support groups can help you a lot in handling your sadness, depression, anxiousness or confused feelings.

What are fibroids? Are they cancerous?
A: Fibroids are formed in the uterus. They are benign tumors which grow from cells forming the muscle of the uterus (womb). Fibroids can be as small as a pea or as large as a football, but whatever their size, they are almost always benign, which means they are not ‘cancer’ and do not increase your risk of cancer. However, if a fibroid is very large and on the uterine wall, it may push the uterus aside or force it to grow abnormally. This may put pressure on the bladder or intestines or block the opening of the uterus and prevent normal delivery.

How do they occur?
A: Changing hormone (estrogen) levels seem to be a major cause of fibroid growth. When estrogen levels are high, due to pregnancy or contraceptive pills, the rate of fibroid growth increases. Fibroids are often found in women of childbearing age, but usually not seen in women under 30 years and are rare in women before the beginning of menstruation. As the woman approaches menopause, her estrogen levels fall, and hence fibroids are most likely to shrink or disappear.

A routine internal examination by your gynecologist or an ultrasound can tell your doctor whether you have an irregular uterus that could be a fibroid.

Can fibroids be treated?
A: Fibroids need to be treated only if their symptoms are troubling you enough to go for relief measures. Treatment will depend upon an examination which tells:

The amount of pain or blood loss during menstrual period

How quickly the fibroid is growing

Your age, since fibroids shrink with the onset of the menopause

Your desire to have children

If fibroids need to be treated, your doctor will know the best way to do it.

Will I be able to have a baby if I have fibroids?
A: In rare cases fibroids can contribute to infertility. Fibroids are said to cause an increased risk of miscarriage in the first and second trimester and an increased risk of premature delivery. Fibroids are also said to reduce the success rate of fertility treatments. However, there is little evidence to prove this and hence we cannot claim that fibroids can cause infertility or reduce fertility.

I bleed heavily due to fibroids. How can I get relief from my pain?
A: Fibroids can cause painful menstruation and heavy bleeding. If this is a continuing problem, it is advisable to see your doctor. Meanwhile to ease your pain you can do the following.
• Take pain relief pills for cramps and body aches
• Rest in bed
• Eat foods high in iron (such as spinach) to avoid anemia caused by heavy    bleeding
• Hold a hot water bottle against your stomach or have a warm bath to help    relieve pain.