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FAQ Archive
 
Contraception in Perimenopause
  • A woman aged 40 or above be given the combined oral contraceptive pill?
  • If a 35 year old woman, who smoked when she was younger, but no longer smokes, can she be given Oral Contraceptive pill?
  • When is OCP completely contra-indicated in peri-menopausal years?
  • What age should women stop using contraceptives?
  • Why should "progestogen only" methods be used in peri-menopausal women?
  • Can a woman with previous history of VTE or IHD be given Progesterone only contraceptives?
  • If she is using an implant or POP as contraceptive, how long should it be continued?
  • If a woman has a Mirena/ LNG- insertion at 45 years, when should she be asked to come back for removal?
  • Can women needing estrogen replacement use LNG-IUS as part of HRT?

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Diabetes in the perimenopausal/menopausal woman
  • When should a woman start testing for impaired glucose tolerance test in the absence of any symptoms.
  • If a woman is shown to have diabetes and she is either put on diet, medicines or insulin, how often should she undergo testing for diabetes?
  • How often should Hb1Ac be tested in maturity onset diabetes?
  • What are the dietary advices to be given to a diabetic woman if she is lean?
  • What are the dietary advices given to a diabetic woman if she is obese?
  • If there is normal control of the glucose levels, is it necessary to look for elevated serum creatinine levels to rule out diabetic nephropathy or
    ophthalmic check up to rule out diabetic retinopathy?
  • What are the indications to look for complications of diabetes?
  • What are the oral antidiabetic drugs available for treatment of maturity onset diabetes?
  • Can a diabetic woman take Hormone replacement therapy?
  • Should a diabetic woman routinely take Vitamin B tablets?
  • Should diabetic women be given omega=3 fatty acids or other antioxidants routinely?
  • Are there medicines to decrease absorption of carbohydrates from the diet? If so areThey helpful in management of diabetes?

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Dysfunctional uterine bleeding in a Perimenopausal / Menopausal woman
  • If a 48 year old woman comes with intermenstrual bleeding with occasional menorrhagia presents to the OPD, and pelvic examination shows a normal uterus with non tender pelvis and a normal looking cervix, what should be the line of management?
  • What should be looked for in Transvaginal ultrasound(TVUS) in a patient with peri menopausal bleeding PV with normal pelvis on per vaginal examination?
  • What is Endometrial sampling? Should Endometrial sampling be done for all women with increased thickness of endometrium?
  • What is sonohysterogram? When does the gynaecologist order this investigation?
  • If endometrial sampling is normal, what should be the first line of management?
  • Should hysteroscopy be done for all patients with dysfunctional uterine bleeding?
  • What are the medical treatment modalities available for treatment of DUB?
  • What is Tranexamic acid? What is the dose and how long in an index month can it be given?
  • What is ormeloxifene? For how many months can treatment with ormeloxifene be given?
  • Is there any difference in medical treatment if there is metabolic syndrome?
  • What is LNG-IUD? What are the effects and side effects?
  • How long can you give medical treatment?
  • In a woman with simple hyperplasia, in the perimenopausal period, is there any need for hysterectomy?
  • In a woman with cystic glandular hyperplasia, in the perimenopausal age, is there any need for hysterectomy?
  • What are the other options beside hysterectomy for a woman who cannot tolerate medical treatment due to side effects or if she has a failure of medical treatment
  • What are the complications of the Ablation Techniques?
  • What is the failure rate of ablation methods? Is it better to do hysterectomy for once and for all?
  • What is the role of D&C in the management of DUB?

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Fibroids in Perimenopausal and Menopausal women
  • What are fibroids?
  • What are the symptoms caused by fibroids?
  • How are fibroids diagnosed?
  • How can you diagnose if the fibroid like lesion on imaging modalities is a fibrosarcoma?
  • What happens to fibroids after menopause?
  • Which are the fibroids that need be treated?
  • What are the medical options available in a patient with fibroid?
  • Can a woman with a fibroid take oral contraceptive pills?
  • Can a woman with asymptomatic fibroids take hormone replacement therapy if she is bothered too much by hot flashes?
  • What is the role of progesterone releasing IUD's in the treatment of fibroids?
  • What are the non medical options available for treatment of fibroids?
  • What is uterine artery embolisation?
  • What is MRI guided ultrasound treatment of fibroids?
  • What are the surgical options available for fibroids?
  • When is myomectomy offered to a perimenopausal woman with fibroids? What are the ways in which it can be done?
  • What is the role of hysterectomy in fibroids?

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Ovarian cysts in the perimenopausal and menopausal woman
  • If a perimenopausal woman complains of mild abdominal pain and she is found to have an ovarian cyst of 4 cm, in one ovary, on ultrasonography, what should be the management?
  • What should be management of a unilocular simple 3-5 cm cyst in a menopausal woman?
  • What should be the management of a multilocular cyst in the post menopausal woman"
  • What should be the management of a menopausal woman with an simple ovarian cyst of larger than 6cm?
  • What are the ultrasound criteria to know if a cyst harbours malignancy?
  • What are the risk factors for ovarian cancer?

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