PCOS & Fertility: What Every Woman Needs to Know!

PCOS & Fertility: What Every Woman Needs to Know!

Author Name:Dr Pal

Youtube Channel Url:https://www.youtube.com/@DrPal

Youtube Video URL:https://www.youtube.com/watch?v=vJDvYiMbH4A



Transcript:
(00:00) how do I know whether I have PCOS they have irregular Cycles they have a lot of fatigue and along with a thinning of hair so as a patient what they need to know is you need lifestyle change I feel there's a lot of self diagnosis going on these days come to a doctor so getting a period delayed for a month is it abnormal definitely that's completely a nowadays specifically for breastfeeding mothers would you even believe when I say that they watch phones while they're feeding their babies I said stop doing that you open
(00:30) up book you will definitely feel sleepy in your experience what is the best time to get pregnant poor women when they come for 2 3 months they don't even enjoy their marriage life all what they have to do is get pregnant because there's a society pressure and I feel really sad for them sometimes Force the man to actually I think that's what we need to do from now on now I have to go against the men I think hello guys this is Dr pal banik welcome to another episode of of a podcast series G feeling with Dr pal we
(01:03) interviewed our friend Dr dpti jamy OBGYN very popular in Chennai we talked about the most popular topic PCS what is PCS what is pcod what is the difference why you should be concerned if there are any persistent symptoms and where you should not be concerned and what is the treatment option which actually works very practical tips have been discussed so if you are a women who are trying to understand more about PC overs and and if you're finding it difficult to conceive and having some infertility issues I think this is a wonderful
(01:36) episode that you should definitely watch I would highly recommend you to watch along with your partner as well because we talked about birth control measures preservation of the ovam preservation of the sperms and what are all the risk and the benefits involved and we also talked about the dietary choices that as a couple that you can do to improve the health of your family so I'm sure you learn a lot from it let's dive deep into it hi DTI hello sir we're doing very good welcome to the show thank you so much for inviting me
(02:03) it's a pleasure to be with you one once more thank you thank you thank you thank you you know I have a lot of uh uh women audience so this show we thought that this discussion would be focused on the most common thing where people are really concerned about where whether they have PC pcod what is this all about uh we have done an episode before uh where we were trying to clarify this but we wanted to go to the next level in this discussion where in case if you are diagnosed what are the steps to be done and everything so right off the bat you
(02:33) are close to like 20 years of experience in this easily so I wanted to ask from a patient standpoint in terms of uh how do I know whether I have PCOS yeah I think that's one of the most common question nowadays as I was discussing one few patients when they come to me they come and tell me the diagnosis themselves I think the information available nowadays in Internet is so much that they self diagnose I tell them no hold on let me tell you you whether you have pcod or PCOS because there's a huge difference
(03:05) between the two and they fail to recognize that I think pcod as it says no D is the disease and S syndrome obviously syndrome now it has something little more than a normal disease would be generally when pcod if I have to give a diagnosis the patient should have either irregular Cycles most commonly they are on the higher BM they do have lean PCOS also but then PC Pak they do have uh on the higher side higher BMI second they have irregular Cycles they have a lot of fatigue and along with that thinning of hair so that's most of
(03:40) the common things with scan findings of of course in ultrasound we have to have a typical pattern of the ovary if it is not there then we don't call it pcod and the typical pattern of the ovaries identified an ultrasound along with all these symptoms is when they labeled as pcod oh syndrome comes when there are signs of insulin resistance or also with the excessive Androgen so how do I know whether it's insulin resistance one either you're into the borderline diabetic range where your metabolic syndrome is starting that means your
(04:09) waist hip ratio is different it's it's not okay second when you have excessive facial hair hairism that tells you that your Androgen or your testosterone hormones are high I think those are into PCOS so the difference between pcod and PCOS is that when your systematic or metabolic aspect is involved that's when you're more prone for type two diabetes your heart risk your cardiovascular risk increases all that falls into the syndromic thing so as a patient what they need to know is you need lifestyle change that's the first thing whether
(04:43) it's a disease or a syndrome you need lifestyle change if at all you're into a higher BMI range then first check on your lifestyle because most of the patients these days they either they they come and tell me I'm stressed what do you do I work 9 to5 job I come home I have my own set of they all have helps or whatever even if they don't have help also they are fine they two member family but still they come and tell me they are stressed even or four fifth standard kid also comes and tells me I'm so stressed because of exams so stress
(05:13) nowadays is a huge concern and also when they have irregular periods they start junk with lot of junk eating I think so what is happening is I have irregular periods I'm Moody I want to eat more let me eat more so let me eat more and sooth myself because only then my mental health is going to be all right so that's becoming a vicious cycle and that cycle or the circle is not broken anywhere that's what is happening nowadays I feel the distinction between a disease and a syndrome is very important and second they should not
(05:45) self diagnose I feel there's a lot of self diagnosis going on these days I think that's the first step come to a doctor it can be a gynecologist it can also be a g medicine or an mbbs person who is know who knows what PCOS or pcod is I think self diagnosis nowadays is becoming a lot if they have irregular periods the first thing they think is I have pcod I said no wait let me scan and tell you whether it is a pcod or PCOS and based on that we'll start treating from a patient standpoint let's say I H I have a 18-year-old daughter uh who's
(06:20) having irregular periods this really happened actually my family member they took him to the they took her to the doctor the doctor said you PC okay they really got so stressed so they call me in the middle of the night that okay my daughter is not going to get married I mean going to have difficulties in marriage they will not be able to conceive what will I do and everything so I said you know first let's analyze what's happening um so what are all the other reason that could be for irregular periods so basically what's happening is
(06:50) PCOS or pcod whatever they considered as one of the most commonest reason for irregular periods that's well known nowadays because there's a lot of information available on social media so what do patients think is they think that that's the only reason that's the first thing second they don't even evaluate thyroid most of the time so hypothyroid is also one of the most common reasons why your periods get irregular and third overweight overweight or even obesity and particularly when you say 18y old I can understand the stress she's going
(07:21) through she would have just finished her 10th or 11th or she must be giving her board exams the stress sleeplessness undue amount of no physical activity the minute the kid goes into 9th or 10th grade they're pushed into only studies all those years they' be doing some amount of physical activity they would be in sport or they would be dancing that's all completely shut by the time they come off to their board exams so it becomes extremely difficult for parents to accept that and the minute they say p i I should even also say the scan people
(07:51) so even when they scan it's very important that we give a diagnosis of PCOS only when all the symptoms are me in the G the criteria has to be met before you even comment or utter the word as polycystic the first thing they think is I have too many cyst in my ovary that's not how it is it's just the pattern of the ovary and the pattern of the ovary is it's actually a misn noral polycystic ovarian syndrome or a disease is a misn Nora it's that doesn't mean that you have too many cyst in your ovary they are follicles I easily
(08:22) explained to one of the whenever patients come to me for irregular periods I said why doctor why am I not getting regular periods so the the easiest way I could probably put it across to patients is that when you probably say uh you have 40 students in a class and in a month there should be only one student who can become the leader of the class there's no one student everyone wants to become the leader so the the leader is Not Elected by the end so the one man just passed by without any leader so that's very simple
(08:52) very typical of a polycistic uh ovary one of your egg doesn't get mature in that month by 15th day that egg should be matured until 30 days 40 days 50 days they still electing the leader that means the one of the egg is not selected at all so that's why only when you have the egg selected and it becomes mature it becomes a leader when it does not fuse with the sperm you're not going to have pregnancy you're going to have periods so this way the patients understand a lot better I tell them so what do you need to do for you to
(09:23) ovulate regularly so the minute you ovate the egg releases you're going to get periods within 2 weeks the first thing I always believe is lifestyle lifestyle change Let It Be 11th grade or 12th grade even we did our 10th and 11th even we were also studying it's not that we didn't study but I feel nowadays the kids are already pushed they starting need coaching from eighth grade itself I see few kids starting from sth and eth so it's become a lot the the thing is that you have to study so there's no physical activity at all I tell parents
(09:53) let them study but the topic which they're going to study for 3 hours if you allow them to send for some physical activity they'll finish off in 1 hour M ask them to play for half an hour or 1 hour they can play batminton they can play racket Sports swimming anything study the same topic and they'll finish off in 1 hour which they supposed to do in three hours and it actually clicks swimming helps a lot the only thing is any any physical activity is fine but a kid needs physical activity that's first genetics of course we can't go in and
(10:21) change their genetics but I feel a lot to do with stress sleeplessness junk lifestyle changes are the pointers apart from thyroid thyroid PCOS and apart from all this insulin resistant things these are the common reasons why you could have irregular p in your practice you keep mentioning stress repeatedly okay is that a reason that you're mentioning it because it's getting very common or is that one of the most important factor that we no it does it actually makes a difference because your hormones get affected when you're stressed uh when
(10:52) you don't sleep properly when you're not having your food prop for example when you uh when you even overeat or undereat both actually has an impact on your adipo cells and that also has a direct impact on your estrogens and that irregular makes your Cycles irregular it's extremely common so stress does play a major role in your period cycle I feel when you ask them uh probably when they shift their houses or they have not slept for long or they had their exams going on those periods get delayed and once the kids exams are over or anything
(11:24) and then just gets regularized just like that without even medications stress does play a huge role in cycle regularity so getting a period delayed for a month is it abnormal actually not actually let them not stress about it I always tell them if your Cycles are regular that's good so regular Cycles means every monthly on so monthly once is probably 30 days so have plus or minus 5 days from 25 days to 35 days it's considered regular so when your periods probably you're not getting your periods Beyond 35 say for example a week
(11:55) or 10 days or probably 45 days or 50 days then you go meet a doctor but that that doesn't mean it's really abnormal the first thing you need to check is what happened over the past one month or two months if you feel that you've not been doing what you routinely do or if you feel that this is not a routine thing don't jump in and think that there's something abnormal don't get scared if this is a pattern you're seeing over a period of 3 months or four months then it's very important that you evaluate your hormones then you do your
(12:24) scan ultrasound pelvis scan to check if there's any cyst or anything to do with your hormon like thyroid or even anemia for that matter many patients I've seen patients with 6 G 7 G hemoglobin the minute you correct their anemia the periods get regular so it's it's extremely common the most easy easily treatable causes we miss and that's very very important for us to know that all irregular periods you don't have to worry and if it's a pattern over a period of 3 to 6 months and I tell my patients to maintain a diary is called
(12:55) menstrual diary so I tell them I mean nowadays no one is writing a diary but tell them to look it off their chart because that actually tells you you might not even remember when you got your last period but then making a note of it for 3 months to 6 months actually helps the doctor in analyzing your on the period cycle so I think just one month irregular period or just delayed periods I think you should not worry much over a period of time if it is yes definitely you need to evaluate in your practice when you think stress is a
(13:24) reason for this delayed periods or maybe a combination of PC pcod what is the first thing that you do I just tell them to stop their Gadget usage that's the first thing most of the kids these days the teens and even the uh mothers or young mothers as much as much as they tell their kids not to use Gadget I said just first start practicing yourself even if it's going to be my video or even Dr Paul's video you watch it before 7:00 you stop using phones after 8 because that definitely hampers the entire lifestyle not just
(13:55) the mother the entire family because the kids are going to have their dinner late they're going to sleep late the next day is going to get messed up so I feel the first thing for stress is there and also on the contary if you see the secondary effect of it you sit down and watch a video you don't keep doing cycling or you don't keep jogging and watch a video right so of course your sedentary Lifest also it's an add-on the minute you start your phones I feel that's the first thing and check on your sleep the minute
(14:22) you stop the gadget it's all like a again a circle your sleep gets better read a book if you're feeling if you don't feel sleep sleepy probably go for a walk have a light dinner go for a walk read a book and you'll automatically feel sleepy you open a book you will definitely feel sleepy no matter what book it is I think garget usage nowadays specifically for breastfeeding mothers would you even believe when I say that they watch phones while they're feeding their babies I said stop doing that doctor what do I do every 2 hours every
(14:54) 3 hours I'm feeding and I'm just bored what do I do I'm sitting in the room no no one is there to talk to me I just have my phones I said that's the time that you need to be with the baby how many months are you going to breastfeed how many years are you going to breastfeed make sure that you have a skin- to- skinin contact talk to the baby be with the baby you can play soft music in the room make the room uh calm and dimlet so that it's easy for the baby to come and have a good meal that time and I think you should avoid phones
(15:25) during uh feeding and also maximum during pregnancy because um I think there's lot of information available on the social media and I think patients should know whom they are getting that information from I think that needs to be conveyed to the patient because randomly they get a lot of information they don't know how to process that information that's adding stress and ultimately they are going in to find the answer in the next next videos and of course that's that's an never ending so what should the breastfeeding
(15:55) mother do while she is feeding the baby that's a wonderful question because breastfeeding mothers generally when they feed we still in India we don't uh there are uh couple of places where we can cover ourself and feed or we do have public places where they have separately given for feeding but still breastfeeding mother wants to be alone isn't it and at the time of breastfeeding no one enters the room most of the time there's not many people who enter the room they are inside a closed space and that's the phase that
(16:22) they actually go through soon after delivery it can be a first time mother it can be a second time mother doesn't matter but then that's a phase where her hormones are like going up and down and she's most of the time alone if not for her family of course and imagine in a room in an Indian scenario when the mother is going to feed the baby is crying of course everyone will shut the door and go out okay you feed I'll wait outside so that's exactly what any grandmother or any grandparent would do so when that happens what happens is
(16:51) that mother does not have anyone to talk to there we don't want anyone to talk to but you have a little one there so I always tell them whenever they come to me Post delivery to check if everything is fine I tell them talk to the baby that skin to- skin contact is extremely important I think the the room skin to skin is the baby baby to the mother's skin that's extremely crucial because that actually calms the baby down a crying baby even if you don't feed you actually promote skin to- skinin contact the baby settles down very soon even you
(17:23) wrap or if you can remove the wrap and put the baby onto your skin even if the father was going to do that actually settles down the baby a crying baby and a mother who's going to have skin to- skin contact and see for examp just imagine for an example she's going to have a baby feeding on one side she's going to watch phone I mean that's not what you want to do as much as it's so easily available you don't want to switch on a TV or you don't want to watch iPad when the time you're feeding because the baby is there right next to
(17:51) you you can cuddle the baby you can pad the baby you can actually make sure that the baby's comfortable you can position yourself so that you don't have back pain or you don't have any um issues with your abdominal pain so you can do many things when you're feeding a baby just think about the baby you can sing songs you can have a mild music which is running in your room you can calm your room down so that the baby is also settled down so I think that's very important it increases the bonding it definitely increases the bonding because
(18:19) the bonding which the mother and baby gets during the feeding time you will not get it anytime that's very very important for your patients how long do you recommend breastfeeding basically exclusive breast feeding is up till 6 months so until you start solids by 6 or 7 months but then you can go up till 1 year or 2 years also you can go up till 2 years plenty of studies who say that which says that up till two years has excellent immunity for the newborn as well so we do not stop them even if the mother gets pregnant say the baby is
(18:45) Oney old she's feeding and she's pregnant the second time we encourage the mother to feed the child even if you are pregnant now it's okay because patients have a lot of opinions on that how can I feed my first kid doctor because I'm pregnant now my this kid needs milk I said milk you will get milk so don't worry just supplement yourself with good amount of calcium in your diet and supplements which we give you can definitely feed your child a common thing that I get is okay if I get diagnos with P overs I'm not going to
(19:12) get pregnant your experience on that in terms of what is the prognosis of the disease whether it's PCS is better pcod is better okay so basically the first thing they need to understand is not that they not going to get pregnant at all definitely that's completely a myth you just have to make there's so many follic like how I told the story you just have to make sure that one egg is released and one egg in one sperm is enough to make a baby the problem they get scared is that when they don't ovulate that is when the egg is not
(19:42) getting mature that's the issue and PC OD uh as long as your lifestyle changes are corrected the patients do very well your PCOS that means you're already into the metabolic syndrome and endocrine issues right so the thing is apart from Lifestyle Changes they need treatment either we have to give them hormone supplements or we need to induce we need to give a little bit more push through our through our hormones and injections or tablets to make the egg become more mature that's what we need to do but there's absolutely nothing that they
(20:12) cannot conceive they can definitely conceive but if for our medicines to work their lifestyle changes has to cooperate because that has to happen and we can't just keep doing our medicines how many doses of medicines can I give how many doses of gonadotropins or any other hormone injections can I give as long as they going to work on their lifestyle even 5 to 7% reduction in their body weight can make them overate more than 75 to 80% of them over late just by reducing 7% of their body weight if I tell them this they're actually
(20:45) ready to do it I've seen so many patients I actually tell them this is a deal I'll see you in 3 months it's a deal I'm not going to give you any medicines but if you can if they are around 27 28 we generally don't start treatment for infertility immediately once once they get once they get married at least we all love them for one year or two years also if they are only 25 26 by the time most of them conceive naturally income we now we've started playing a game okay now let's stay I'll also do workout every day you also do
(21:13) workout every day and then let's see how it is at the end of three months so I've started doing like that and that actually motivates them a lot there's a community where there a couple of patients who are ready to be in a community like a WhatsApp group or something we we are a part of that group where they motivate each other that's a Wonder thing and they motivate each other in Step count or I did the workout and that's what I had for lunch I think group workout at least doing it for their better corre I think PCOS should
(21:39) not be considered as a place where they have to go only for treatment or IVF they can do it for our treatment to work even with normal hormone medicines I think their lifestyle changes will help a lot you talked about the ages like 25 26 in your experience what is the best time to get pregnant if I say no this then everyone are going to get really angry that as a working mother the ideal age let me tell you as a fetal medicine consultant also because I see a lot of fetuses in scan pregnancy scans when the mother is around 24 early
(22:12) 20s not very early like 1920 I'm not saying that after 22 23 like 24 25ish that's the best time and uh earlier they used to get married when they were 21 22 and they had their first kid by 25 and before 272 they're done with their family on the contrary now for the good for the better definitely women are into their career and they want to do well but at the same time I would tell them that uh career is going to go it's not going to go anywhere you will get to go where you are but if you're motivated to do that you will be there but at the
(22:46) same time don't give this don't leave this I generally tell them if you're getting married by around 24 25 years plan your pregnancy one or two years and at the same time you'll have energy to take care of your baby and if you're motivated enough you will reach the goal in your career in your professional life as well because as a professional woman who works who has a pre-teen daughter and doing my work it's extremely difficult difficult it's not easy it is difficult I agree but then there's nothing that you can't do if you have a
(23:14) mind heart and soul to it you can definitely achieve it and do not delay your pregnancy for this because I have seen uh chromosome problems that's like abnormalities where genetic issues or chromosome problems for very young girls like when they get married by 18 19 very early pregnancies and later pregnancies more5 more than 35 37 so everyone thinks that oh let let them get married at 18 they'll have their first kid no we've had more number of chromosomal abnormalities before 20 before 1918 and all and after 35 36 37 nowadays we
(23:49) considered Advanced Metal age only after 377 earlier we used to take it as 35 now we all shifted but generally we have enough data and we have many things to identify if there could be a chromosomal abnormality but if you have an option to have a pregnancy have it before 30 Before 30 Before 30 yeah if you get married by 2425 complete your family I'm going to Ste this controversy even more where you know people are not finding the right person okay so you know arrange managers man doesn't matter but you're not finding the right person so
(24:22) they're delaying the so the argument is that okay why should I get into a marriage to get pregnant if my I'm not sure whether it's the right marriage or not in that case scenario let's say that is the preservation of their ovam and everything is uh do you recommend of course yes because that's one of the uh new things which has come up we've been doing it for quite some time actually but suddenly it's cropped up now but in this in the sense it's good in a way because they don't know that they can actually do it earlier and all we used
(24:51) to do it for IVF pregnancies and ARS we used to freeze our eggs uh even sperms as well because there are there are husbands who work in Navy who are Sailors who go to the ship they are available only for 3 months in a year they're available only for four months in a year and poor women when they come for 2 three months they don't even enjoy their marriage life all what they have to do is get pregnant because there's a society pressure and I feel really sad for them I said don't worry first have good time spend time with each other for
(25:18) one one month or two months and even if you can't conceive naturally it's okay tell them probably you can freeze their sperms and if that's the issue with the husband not staying with the women or for a woman who who really wants to plan her career ahead and who have not decided when to get married as as you said that you have not seen the right person you can definitely freeze your eggs freeze your eggs anytime because not complicated absolutely not absolutely not and the eggs it's so safe because that's even if you are going to
(25:48) be 34 35 or even 37 your eggs are going to be 25 and you can actually bu it and then doesn't matter doesn't matter the AG is still the age the eggs is still the age when you actually preserved it your age can be 35 36 but the age when you preserve the egg is 25 your egg age is still the same it has to be stored in a place and that can be reused anytime so it's very important that patients know if they are going to plan pregnancy later and when they know that they're going to get married later we've had plenty of patients who come in even
(26:19) unmarried not just celebrities we've had regular uh patients yeah yeah common people coming in and asking us I feel that's for good ni I feel that's for good they don't have to compromise on their career just because that they have to get married no okay I have to have a baby before 30 so I have to get married at 24 no nothing like that if you in a scenario where you get married early try to have pregnan your babies earlier but if in case that you can't get married for whatever reason it is then you can easily preserve your so telling me it's
(26:47) a safe procedure it is absolutely outcome is better yes and even if you take is there a age limit like 36 37 doesn't matter how long does it last generally before 35 because after 35 uh there's a sharp decline in theeg quality which we don't want so preserving an egg after 35 36 37 we generally don't preserve all the eggs we detri the eggs we see the quality of eggs so there's grading of eggs like how we grade embryos once it's made we have grading of eggs also so we take good quality eggs and preserve it so
(27:18) generally preferably to preserve if you're thinking before 30 about 35 36 the a quality does decline how about preserving at 25 and how long can we use that EG like 3730 doesn't matter anytime anytime yeah anytime you can preserve it even for lifelong so it's anytime you can use it 10 years later 15 years later anytime doesn't matter that's actually yeah because all this started only when IVF started and we did preserve Ides because if first cycle Iva failed we don't have to again give hormones for the mother or the patient and again
(27:53) retrieve the egg again she has to go through a procedure for anesthesia so what we do we retrieve eggs St it freeze it so that the IVF Cycles can have only Embryo transfer just the baby getting transferred she doesn't have to go through the process of hormone injections every time wow that's very difficult for a mother to go through plenty of injections and it's emotionally also very traumatizing it's not that easy we can give injections and see but it's not that easy easy when a patient comes to you and then says that
(28:18) hey you know I want my uh egg to be Frozen now what is the societal pressure that the patient is undergoing actually the patients do come alone alone yeah they don't come with family more than uh 90% of them they actually come alone either they come with their um partner or a fiance or whoever or whether they're planning to get married or they don't come with their parents yet I think now we've still not opened up to that Forum because I think parents uh of course their parents are going to be 1960s or 1970s they've still not opened
(28:51) up to that uh level but then patients young girls do come I'm still not with the parents I'm not sure if the parents are aware of it but young girls do come without the parents though I'm just talking to talk about men now yeah I think that's I think that's also important is this applied to men I mean freezing this yes yes it does we recently we had um I think very a celebrity also I think they preserved a singer I don't remember his name but then they preserved his firm and they have a kid from him now the parents the
(29:24) singer somehow I think unfortunately could and then they have the kid from by using his pumm so anything is possible age limit for men where the risk of chromos generally no5 around 45 50 because the spermatogenesis does every 72 days once so new fresh quality of swamps generally around until 45 it should be good because and also it's not only AB age it's about the other Habits Like BMI smoking your alcohol and everything plays a role so what happens is that as you age your metabolic disorders also increases so that also has an effect on
(30:05) your egg and sperm quality so the earlier the better ear the better even for men even for men not just sperms as I said not only eggs even for sperms earlier the better so I don't practice in India but when I was uh medical school and I was uh doing medicine over here I see a couple coming into the obgy clinic uh they would try one year of natural uh conception didn't happen they're coming and invariably infertility discussion was only attri discussed with the women is this the same case now or has it improved no
(30:37) definitely has improved definitely because the time when we were start and even I was staring I think almost the same time it will be only the mother the woman and her mother or the Mother-in-law the husband won't even be in the scene but nowadays it's completely different and I do see a lot of husbands being involved in women's health the first question they ask me is is she okay doctor is she okay if she is fine if everything is fine then we're okay to do I see a huge difference over a decade now 10 within 10 to 15 years um
(31:08) it's a lot but still we do have patients where the husband doesn't come he feels that he is not responsible for anything they are there but there's a huge drastic change from what we saw earlier in our PG days and postgraduates and from now I think the husbands are definitely involved I should give it to them they're definitely involved in thank you I I should say that that's the truth the the other angle to this is Translating that okay so you have a IVF infertility difficulty in conception the other angle to this is you are naturally
(31:39) conceived you have two little kids and now you're planning for uh birth control again the same question where traditionally tub liation where you tie the tubes of the from the coming from the ovary in the women has being one of the birth control method or oral contraceptive pills where we give to the women true how about vasectomy in men why is that a big thing in the US and not in India I don't think it's still much it's not catching up now I have to go against the men I think I think for once because no I think that's still not
(32:12) come up what do you think so I feel the awareness is not there yeah I feel the awareness is not there the easy thing for them to say you just got you finished family and earlier in all we used to do cesarian section along with that we used to do family plan we would just ask them tub legation said they'll give consent form they'll be very happy no matter what but nowadays we're actually postponing it we not doing it with the elective cerian if even if it's a second pregnancy what we tell the mothers is wait wait for the kid to
(32:40) develop 2 years 3 years let the kid become two years let the child start talking let the brain development be okay let the baby have a normal development and then you come for laparoscopic sterilization because that's a daycare procedure and your tubal liation you earlier we used to do a mini laprotomy open and do along if it's not aan if it's a vaginal delivery we'll open and do nowadays we tell them you can do laproscopy but allow the baby to grow for 2 years only after 2 years we accept them for a laparoscopic
(33:08) sterilization unfortunately I feel still vasectomy is not picked up and tell to audience what is vasectomy vasectomy is just like as much as ligating the tube for the women it's like ligating the vast difference obviously the tube which connects where it it makes sure that the sperm gets ejaculated outside that tube so that your sperm production quantity everything will be normal like how the patient is going to woman is going to have her periods regularly similarly the men is also going to have the same thing
(33:38) just that the tubes would be like it it because in your ejaculated the sperms will not come so that the woman will not get pregnant pregnant correct that's the only thing but I feel the I think we'll only have to create awareness about vasectomy I think that's actually it's also a very simple procedure proced much simpler than a than a tubal liation and also the birth control pills oh actually can't give birth control pills for too long that's the problem because not more than 3 to 6 months because even the
(34:04) birth control pills have their own disadvantages right you there's a very rare complication of an thromboembolism a blood clot blood clot a blood clot it can uh lead to a stroke you can have you can even have ovarian or breast cancers also with excessive use of oral pills be very careful with the type of pills we using not more than 3 to 6 months so that's not a long-term method I see we can't use that a longterm method the other one is a coery that is like a inside for at least for five years but then if you want a permanent method it's
(34:36) either a tubal liation for the woman or a vasectomy for a tube liation for the partner I feel the I think the awareness is that that the men think that they will lose their masculinity or I think that's that's one of the reasons why they've still not uh come up for that they caught up with that and it has to be done by a surgeon and that also so the thing is they can't wear comfortable clothes after that at least for the first first one few weeks they will have to they can't wear pants and I feel uh I think a working that's the slightest
(35:11) inconvenience that's true actually compared to the multiple incen women is going through true seriously I think I am a very strong proponent of asy because I see that is very commonly happening in the US to a point that the women I mean this is this is I see my patients they sometimes Force the man to actually I think that's what we need to do from now on because for for the wom to get admitted and then go back return to her routine life and take care of the children it's easy for the men to go it's painless relatively painless
(35:45) seriously actually done to local Kur yeah yeah sometimes you can I mean I'm not saying you should do it but then that's it can be done it's that it's not a very difficult procedure I think once they know that your masculinity will not go down and just the angle that you know this is a very simple procedure compared to the side effects that the women can go through I'm a very big prop of it uh that's why the government is also giving some incentives over here I I'm sure I think after this video many men or many
(36:12) women will force them get them as to me done already many men are actually hating me to the court you're going to get lot more than so uh you know the reason we talk about this is that the pcover infertility and all these birth control everything comes under a bigger lifestyle uh umbrella true how is Diet playing a role in your treatment of P I think diet is one of the major things apart from medicines whenever I give medicines for like hormones or anything I tell them as long as you're not going to fix your diet I'm not going to give
(36:46) you medicine because my medicine will work anything for that matter I'm going to give medicine for your insulin resistance or anything whenever I give it will work only when you are going to be on a diet and the thing when I say diet they think that they should not eat I think that to break that myth takes a lot of time to have them come to the picture and say that diet is not not eating diet is eating in the right quantity at the right time so that makes a huge difference because nowadays when you talk when you tell them doctor we
(37:17) come back only by 9:30 10 both of us are working I feel so tired to cook and eat or have a dinner much earlier I tell them finish your dinner before 7: no doctor that's not possible we come back and we see in Ana nagar we see food coat we stand there we have Biryani and come and what time do you have 10 10:30 that's not going to work but when you're having planning a pregnancy as much as you want it to be a healthy pregnancy you need to prepare your body as well as people think that it's only women I I definitely again for the men aspect they
(37:48) have to prepare themselves also because the quality the quality of the sperm yeah it makes a huge difference in miscarriages how many of them think that miscarriage is only thing how many of them know that it's because it could also depend on the sperm it could also depend on the quality of the sperm that a miscarrage can happen never always the woman's fault I think it's extremely important that your diet not just smoking and alcohol your timing of food the quantity and what you eat I just I tell them don't make it simple just make
(38:20) sure that every meal you have one fruit one vegetable just start with that that's your first week goal I give them 12 week's goal literally I tell them weekly once you incorporate one one idea then every idea you should add on to the next week first week is incorporate one fruit and one vegetable second week make sure that you have at least 2 to three liters of water include that fruit and water third week you check because if I bombard them was too much information of the first time they won't come back to
(38:46) be next day I have they'll be doctor said I have to lose weight I have to diet I'll not eat anything and finally they'll lose 2 kgs that'll be only water loss then they'll come back gaining three more kgs than what they have lost earlier so I'll tell them start with small small steps Tiny Steps as much as possible incorporate those so that it becomes a lifestyle so including a fruit and a vegetable specifically in your every meal makes a huge difference because that increases their fiber intake second you increase their
(39:17) hydration they increase their water intake third fix their sleep fourth tweak then Gadget so small small things you tweak a little bit actually they feel a lot better yeah definitely what is the most common dietary mistake that your PC patient would do most common right you know generally when they feel a lot uh moody or when they feel very when they don't get periods what happens is the progesterone completely there's hardly uh not good amount of progesterone in their body to let go of periods but then they do have lot of
(39:47) bloating and heaviness mood swings and all and the minute they have all that they'll have to have something sweet sweet something sugar gra no doctor they I have to eat something sweet how can I sleep without having sweet I'm I'm having so mood so much of mood swings I'm shouting I need to have something sweet so either they junk itat easy thing is to order we have everything available nowadays and they just order food it's either an ice cream or a donut or a pastry I feel that's where they they get into a cycle that okay it's
(40:20) okay it's only today right it's only today right so they don't even understand even when they have menstrual cramps the worst part is is having junk actually menstrual camps gets easily alleviated when you avoid junks avoid caffeine avoid junk your cramps actually reduce it's better you increase seeds in your diet you have actually you can actually even work out if you feel good and yoga just a walk or bris walk or even if you there are menstrual CS now with cups you can even swim you can wear a menual cup and minut and swim if
(40:53) you are a good swimmer or you like swimming actually that relieves your cramps a lot better I see I tell them stop junk eating I think most of the things they do is to eat junk I think and process food and they feel that it's only today it's just one day and that actually continues their entire day until that they don't get their periods again it's bloated and again they feel dull and then they have to come to us for a medicine to withdraw and then get their periods I think most common mistake is they have lot of sugary
(41:23) processed uh food nice nice wonderful discussion as usual thank you thank you so much for such a wonderful Insight thank you so much and keep doing good work keep spreading the word okay and my wishes to you all trying very different things and I hope I'm sure patients are really really happy and it population deserves a lot of information like this because gut health became popular only after you started talking about it I think that's um very similar to how you do uh people when they come and they say you know I lost my some weight because
(41:55) of you I feel happy and that keeps me going and I think every doctor should be on social media promoting their expertise and thank you so much for your hard work commitment and uh wonderful te thank you so much convey my regards to PRS of course it's been so long since I met her it's been a year close to a year convey my regards to her of course of course nice meeting you thank you we'll meet up soon thank you hello guys there was a wonderful podcast session I absolutely enjoyed it I'm sure that you would have enjoyed it as well lots of
(42:23) take- Home points I really want you to obsorb the discussion and see whether how you can practically Implement that into your lifestyle so I'm sure that this will definitely help you in smaller steps to reach your long-term outcome so the other important announcement I want to give you is we do have a holistic gut health program called new me this is not only helpful for weight loss all pcover patients hypothyroidism or any kind of insulin resistance related problems we would be happy to help you out this is a
(42:54) program that I am very passionate about I put this together in ter terms of what I will expect if I am a patient check that link in the pin the comment and explore it more as usual it is one Billy at a time it is absolutely important stay happy stay gutsy may God bless you