Aesthetic Services
Dr Leneque Lindeque is a female Obstetrician & Aesthetic Gynaecologist based in Hilton.
Visit her practice at 4B, First Floor, Hilton Health, 3 Monzali Drive, Hilton Gardens, Kwa-Zulu Natal.
Annual gynae checkup
About Annual Exams
For many women, the thought of attending an annual gynaecological exam can bring up feelings of embarrassment or anxiety, which, unfortunately, may lead to avoidance. Some women choose not to visit their gynaecologist for modesty reasons or possibly because they are worried something may be wrong. In reality, annual gynaecological exams are incredibly important for all women.
The benefits of annual exams far outweigh the dread that many women experience. We’ll discuss why gynaecological exams are needed, what to expect during your exam, and why it’s essential to get them on a yearly basis.
Annual gynaecological exams are often referred to as “well women exams,” or “well women check-ups,” to help reassure and reduce any anxiety caused by going to the gynaecologist. The American College of Obstetrics and Gynaecology recommends yearly visits for annual exams.
When to get annual gynaecological exams?
- Typically, the first annual exam should occur between the ages of 13 to 15. Pelvic exams are usually not required during these first visits.
- Around the age of 19, many annual exams will include pelvic exams and also check for breast and abdominal issues.
- Pap smear testing begins at age 21.
Some women may feel that you’re only supposed to go to an annual exam to collect a pap smear, which isn’t entirely true. While many women will receive a pap smear at three or five-year intervals, gynaecological exams check for more and offer an appropriate time for you to discuss any changes, experiences, or concerns about your gynaecological health. These exams also provide an excellent time to check for preventable diseases such as cervical cancer. The risk of cervical cancer does decrease with age, but as women get older, they often have an increased risk for other cancers like uterine, ovarian, and breast cancer—all of which an annual exam can assess.
Exam Expectations
During an annual exam, you’ll have a comprehensive medical history taken to assess any potential risk for familial cancer and other hereditary health issues. You will also have a physical exam performed which checks vital stats like blood pressure, height, and weight. Depending upon the age of the patient, there will be a pelvic exam, and a breast exam conducted, as well as, evaluation of symptoms, screenings, and counselling. Furthermore, if a patient is sexually active, a provider may test for common sexually transmitted diseases like chlamydia, gonorrhoea, and HIV.
Counselling is an integral part of an annual exam. It’s crucial to be as honest as possible with your provider so that they can help with any issues that arise. While talking with your provider, they may address other topics such as:
- Nutrition
- Physical Activity
- Sexual Practices
- Sexually Transmitted Diseases
- Menstrual Cycle
- Pregnancy
- Contraceptives
- Hormones
- Urinary Symptoms
- Pelvic Symptoms
- Menopause Symptoms
- Screenings (cholesterol, diabetes, thyroid, colonoscopy, mammograms, etc.)
- Mental Health
- Vaccinations
- Tobacco Use
- Alcohol Use
- Drug Use
- Other Health Issues
5 Reasons Why Annual Exams are Important
Without an annual exam, patients run the risk of developing gynaecological health and pelvic-related issues that could have either been prevented or stopped early-on, so they don’t turn into a more significant problem. Here are five reasons why it’s incredibly important to have your yearly check-up with your OBGYN.
- Promote Patient-Provider Relations: Annual exams help promote provider-patient relationships where women can discuss reproductive development, menstrual cycles, and ways to prevent pregnancy, prenatal care, and family planning. It’s especially important for patients to feel comfortable discussing anything with their OBGYN.
- Easy Shift in Care: Forming that bond with a patient-provider means that when you’re ready to make the shift from preventive care to prenatal care and family planning, you’ll already have that relationship developed and you’ll know you’ll be in good hands.
- Product Innovation: Attending your annual exam means you’ll be in-the-know about new gynaecological innovations. With technology evolving at a fast pace, you’ll be able to learn about new diagnostic tests, preventative measures, and contraceptives such as permanent birth control which leaves you with more options to choose from when it comes to your body and your health.
- Update Your Health:Annual exams allow patients to catch up on vaccines missed during childhood or have additional screenings conducted to check for various health conditions. Plus, they are a good way for you to know what’s going on with your gynaecological health.
- Prevent Future Issues:We hear stories all the time about preventative screenings saving someone’s life, and it might just be yours. Annual exams check for symptoms such as unusual bleeding or vaginal discharge which may be signs of a disease in a later stage. With a myriad of preventative screenings and tests you’ll be able to take charge of your health by, hopefully, preventing a serious disease.
Is for sure—you should schedule your annual exam before it’s too late!
Family planning & contraception
Family Planning
If you want to have a baby, it is important to prepare for pregnancy, not simply “go off your birth control method.” The way each woman prepares will be different; some may need to change medications, and others may need to stop smoking. Others may need to significantly increase their intake of folic acid.
Even if a woman is considered healthy, she should still schedule a consultation with her gynecologist to help ensure she and her baby will be as healthy as possible.
For some women, preparing for pregnancy can take a few months or longer, and therefore it is important to consult with your gynecologist prior to going off your birth control. Remember to include your partner in this family planning process, too.
Contraception Counseling
When it comes to contraception, there are many options to choose from and each have their pluses and minuses. While you likely already know about birth control pills and condoms, there are other options you might not know as much about that could be good choices for you.
Our physicians can counsel you on the pros and cons of each option, taking into consideration your overall health, your lifestyle and habits, and other factors.
Variety of Options Available
Prior to your appointment at our center, you may want to learn the basics about the range of choices available to you. Below are descriptions of types of contraception you may want to consider:
Hormonal Contraception Options
Hormonal methods prevent pregnancy by preventing ovulation.
- Birth Control Pill: An oral contraceptive that is taken every day
- Contraceptive Patch: A thin, flexible patch that you adhere to on your upper outer arm, buttocks, stomach or back every three weeks
- Vaginal Contraceptive Ring: A thin, flexible ring that is inserted into your vagina and left for three weeks
- Hormone Shots: A hormone shot that is typically injected in your arm every three months
- Hormone Implant: A thin, flexible piece of plastic that is inserted into your upper arm. One implant prevents pregnancy for up to 3 years, but your doctor can remove the implant at any time.
- Intrauterine Device (IUD): A small, T-shaped device with a string attached. The IUD is placed the uterus during a visit to our office and remains there until we remove it.
Barrier Contraception Options
Barrier methods work by blocking sperm from the uterus.
- Spermicide: A substance that stops sperm from moving
- Diaphragm: A dome-shaped cup that fits over the opening of the uterus and is used with spermicide. Your physician will determine the correct size and fit for you.
- Cervical Cap: A silicone cup that is inserted into the vagina and fits over the cervix. Your physician will determine which size you need.
- Contraceptive Sponge: A small foam sponge that contains spermicide. It is inserted into the vagina and covers the cervix. You do not need a prescription for the sponge.
- Condoms: A latex sheath that fits over a man’s penis and traps semen. It is safest when used with other methods of birth control, such as a spermicide.
- Female condoms: A pouch made of thin rubber that includes a ring on each end. It is inserted into the vagina before sexual activity.
Other Contraception Options
- Sterilization: Surgery to permanently prevent pregnancy by closing off the Fallopian tubes so eggs can’t travel through them to reach the uterus
- Natural Family Planning: Requires a couple to learn when a woman can get pregnant during her cycle and avoid intercourse during those days
- Emergency Contraception: Birth control, informally known as “the morning after pill,” that prevents pregnancy after sexual intercourse
Menopause
Menopause happens when you haven’t had a period for 12 straight months and you aren’t pregnant or sick. It’s a normal part of aging. It happens because female sex hormone levels naturally go down as you get older. Your ovaries eventually stop releasing eggs, so you’ll no longer have periods or be able to get pregnant.Most women go through menopause in their 40’s or 50’s.
But that can vary widely. One study found that half of the women in the U.S. reach menopause before about age 52. Some women may go through “the change” earlier if they’ve had surgery to remove their uterus or ovaries or are having certain treatments for cancer.
Are You Headed for Menopause?
You may start to notice changes months or years before you are in menopause. You may have hot flashes and irregular periods. This time is called perimenopause.
You won’t know exactly when your menopause will hit. All you can do is pay attention to how you’re feeling and notice changes. Keep in mind that symptoms vary greatly from woman to woman. Some women have no symptoms at all.
Menstrual irregularities
What is abnormal menstruation?
Most women have menstrual periods that last four to seven days. A woman’s period usually occurs every 28 days, but normal menstrual cycles can range from 21 days to 35 days.
Examples of menstrual problems include:
- Periods that occur less than 21 days or more than 35 days apart
- Missing three or more periods in a row
- Menstrual flow that is much heavier or lighter than usual
- Periods that last longer than seven days
- Periods that are accompanied by pain, cramping, nausea or vomiting
- Bleeding or spotting that happens between periods, after menopause or following sex
Examples of abnormal menstruation include the following:
- Amenorrhea is a condition in which a woman’s periods have stopped completely. The absence of a period for 90 days or more is considered abnormal unless a woman is pregnant, breastfeeding, or going through menopause (which generally occurs for women between ages 45 and 55). Young women who haven’t started menstruating by age 15 or 16 or within three years after their breasts begin to develop are also considered to have amenorrhea.
- Oligomenorrhea refers to periods that occur infrequently.
- Dysmenorrhea refers to painful periods and severe menstrual cramps. Some discomfort during the cycle is normal for most women.
- Abnormal uterine bleeding may apply to a variety of menstrual irregularities, including: a heavier menstrual flow; a period that lasts longer than seven days; or bleeding or spotting between periods, after sex, or after menopause.
What causes abnormal menstruation (periods)?
There are many causes of abnormal periods, ranging from stress to more serious underlying medical conditions:
- Stress and lifestyle factors. Gaining or losing a significant amount of weight, dieting, changes in exercise routines, travel, illness, or other disruptions in a woman’s daily routine can have an impact on her menstrual cycle.
- Birth control pills. Most birth control pills contain a combination of the hormones estrogen and progestin (some contain progestin alone). The pills prevent pregnancy by keeping the ovaries from releasing eggs. Going on or off birth control pills can affect menstruation. Some women have irregular or missed periods for up to six months after discontinuing birth control pills. This is an important consideration when you are planning on conception and becoming pregnant. Women who take birth control pills that contain progestin only may have bleeding between periods.
- Uterine polyps or fibroids. Uterine polyps are small benign (noncancerous) growths in the lining of the uterus. Uterine fibroids are tumors that attach to the wall of the uterus. There may be one or several fibroids that range from as small as an apple seed to the size of a grapefruit. These tumors are usually benign, but they may cause heavy bleeding and pain during periods. If the fibroids are large, they might put pressure on the bladder or rectum, causing discomfort.
- Endometriosis. The endometrial tissue that lines the uterus breaks down every month and is discharged with the menstrual flow. Endometriosis occurs when the endometrial tissue starts to grow outside the uterus. Often, the endometrial tissue attaches itself to the ovaries or fallopian tubes; it sometimes grows on the intestines or other organs in the lower digestive tract and in the area between your rectum and uterus. Endometriosis may cause abnormal bleeding, cramps or pain before and during periods, and painful intercourse.
- Pelvic inflammatory disease. Pelvic inflammatory disease (PID) is a bacterial infection that affects the female reproductive system. Bacteria may enter the vagina via sexual contact and then spread to the uterus and upper genital tract. Bacteria might also enter the reproductive tract via gynecologic procedures or through childbirth, miscarriage, or abortion. Symptoms of PID include a heavy vaginal discharge with an unpleasant odor, irregular periods, pain in the pelvic and lower abdominal areas, fever, nausea, vomiting, or diarrhea.
- Polycystic ovary syndrome. In polycystic ovary syndrome (PCOS), the ovaries make large amounts of androgens, which are male hormones. Small fluid-filled sacs (cysts) may form in the ovaries. These can often been seen on an ultrasound. The hormonal changes can prevent eggs from maturing, and so ovulation may not take place consistently. Sometimes a woman with polycystic ovary syndrome will have irregular periods or stop menstruating completely. In addition, the condition is associated with obesity, infertility and hirsutism (excessive hair growth and acne). This condition may be caused by a hormonal imbalance, although the exact cause is unknown. Treatment of PCOS depends on whether a woman desires pregnancy. If pregnancy is not a goal, then weight loss, oral contraceptive pills, and the medication Metformin® (an insulin sensitizer used in diabetes) can regulate a woman’s cycles. If pregnancy is desired, ovulation-stimulating medications can be tried.
- Premature ovarian insufficiency. This condition occurs in women under age 40 whose ovaries do not function normally. The menstrual cycle stops, similar to menopause. This can occur in patients who are being treated for cancer with chemotherapy and radiation, or if you have a family history of premature ovarian insufficiency or certain chromosomal abnormalities. If this condition occurs, see your physician.
Other causes of abnormal menstruation include:
- Uterine cancer or cervical cancer
- Medications, such as steroids or anticoagulant drugs (blood thinners)
- Medical conditions, such as bleeding disorders, an under- or overactive thyroid gland, or pituitary disorders that affect hormonal balance
- Complications associated with pregnancy, including miscarriage or an ectopic pregnancy (the fertilized egg is implanted outside the uterus; for example, within the fallopian tube)
How is abnormal menstruation (periods) diagnosed?
If any aspect of your menstrual cycle has changed, you should keep an accurate record of when your period begins and ends, including the amount of flow and whether you pass large blood clots. Keep track of any other symptoms, such as bleeding between periods and menstrual cramps or pain.
Your doctor will ask you about your menstrual cycle and medical history. He or she will perform a physical examination, including a pelvic exam and sometimes a Pap test. The doctor might also order certain tests, including the following:
- Blood tests to rule out anemia or other medical disorders
- Vaginal cultures, to look for infections
- A pelvic ultrasound exam to check for uterine fibroids, polyps or an ovarian cyst
- An endometrial biopsy, in which a sample of tissue is removed from the lining of the uterus, to diagnose endometriosis, hormonal imbalance, or cancerous cells. Endometriosis or other conditions may also be diagnosed using a procedure called a laparoscopy, in which the doctor makes a tiny incision in the abdomen and then inserts a thin tube with a light attached to view the uterus and ovaries
Polycysitic ovarian syndrome management
Management & treatment
Management and treatment of PCOS can include a range of elements such as a healthy approach to diet and physical activity, medications and complementary therapies. The following information is a general introduction to the different ways you can manage and treat PCOS.
There are a number of ways to manage the symptoms and the impact of PCOS, so after diagnosis it is important to seek help as soon as you can.
The keys to managing PCOS well include:
- A good understanding of how it’s caused and the effect of PCOS on the body
- A healthy approach to eating and physical activity
- Appropriate medical therapies
Managing PCOS with lifestyle
A healthy lifestyle is one of the most important aspects of managing PCOS successfully.
A healthy diet will ensure you are getting an adequate intake of nutrients, vitamins and minerals.
Loss of excess weight may reduce the severity of some symptoms and will reduce the risk of developing type 2 diabetes and cardiovascular disease.
Even a 5-10% weight loss can have significant health benefits, including improved mood and fertility, more regular menstrual cycles and a reduced risk of diabetes.
Physical activity
Being physically active increases energy levels, helps with self-confidence and motivation and reduces anxiety and depression.
While every bit of physical activity helps, the guidelines recommend that women with PCOS exercise at least 150 minutes per week, of which 90 minutes should be aerobic activity at moderate to high intensity (60-90% of maximum heart rate).
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Managing with medical therapies
There are a number of different medical therapies used to manage the different symptoms of PCOS, including for periods, fertility, excess hair, acne and weight
These therapies may include:
- the oral contraceptive pill
- insulin sensitising drugs such as Metformin
- hormones that are called gonadotrophins
- testosterone lowering drugs
- weight loss drugs
- antidepressants
- anti-anxiety drugs.
Prenatal assessment
How to plan and prepare for a healthy pregnancy
Should I see a doctor before I try to get pregnant?
Yes. It’s very important that you see your doctor or nurse for a “pre-pregnancy check-up.” Your doctor will ask you about things that could affect your pregnancy. For instance, he or she might ask about your diet, lifestyle, use of birth control, past pregnancies, medicines, and any diseases that you have or that run in your family.
There are several things that you and your doctor or nurse can do to make sure that your pregnancy is as healthy as possible. These things should be done before you try to get pregnant:
- Discuss any medicines or herbal drugs you take and find out if you need to make changes
- Discuss whether you are up-to-date on your vaccines
- Start taking a multivitamin that has folic acid(also called folate)
- Know which foods you should avoid and which foods are best
- Stop smoking, drinking alcohol, or taking drugs not prescribed for you by a doctor
- Understand the risks to you and your baby if:
- You have any medical conditions
- There are diseases that run in your family or your partner’s family
- Try to reach a healthy weight
Ask if the medicines you take are safe
If you take any medicines, supplements, or herbal drugs, ask your doctor if it is safe to keep taking them while you are pregnant or trying to get pregnant. Some medicines take a long time to leave your body completely, so it’s important to plan ahead. In some cases, your doctor and nurse will want you to switch to different medicines that are safer for the baby. Your doctor might need to slowly get you off some medicines because it could harm you to stop them all of a sudden. This is especially important for women who take medicines to treat seizures, high blood pressure, lupus, and rheumatoid arthritis.
Check if you need any vaccines
Women who want to get pregnant should be up-to-date on their vaccines. This includes vaccines against measles, mumps, rubella, tetanus, diphtheria, polio, chickenpox (also called varicella), and possibly hepatitis. Many women got these vaccines as children. Still, it is important to check that you have had all the right vaccines. Otherwise, you could get sick with the diseases the vaccines protect against, and that could cause problems for you or your baby. All women should also get a flu shot every year.
Some vaccines cannot be given during pregnancy or in the month before pregnancy. It’s important to get these vaccines more than a month before you start trying to get pregnant.
Start taking a multivitamin
If you want to get pregnant, take a “prenatal” multivitamin every day that has at least 400 micrograms of folic acid. This helps prevent some birth defects. Start taking the multivitamin at least a month before you start trying to get pregnant. It’s not enough to start taking vitamins when you find out you are pregnant. At that point, your baby has already formed many body parts that rely on folic acid and other vitamins to develop normally.
It is important not to take too much of any vitamin during pregnancy, especially vitamin A. Show your doctor the vitamins you plan to take to make sure the doses are safe for you and your baby.
Check your diet
Some foods are not safe for a woman who is pregnant or trying to get pregnant. If you are trying to get pregnant, do not eat raw or undercooked meat. Avoid eating shark, swordfish, king mackerel, or tilefish because they can have high levels of mercury. Check with your doctor or nurse about the safety of fish caught in local rivers and lakes. Limit the amount of caffeine you have by not drinking more than 1 or 2 cups of coffee each day. Tea and cola also contain caffeine, but usually not as much as coffee. Try to eat a balanced diet rich in fruits, vegetables, and whole grains. Wash fruits and vegetables before eating them.
Stop smoking, drinking alcohol, or taking illegal drugs
If you smoke, drink alcohol, or take drugs not prescribed for you by a doctor, now more than ever it is important that you stop. Even small amounts of these substances from time to time during pregnancy could hurt your baby. This includes electronic cigarettes (“vaping”) or marijuana.
It’s not enough to stop as soon as you find out you are pregnant. By then the baby has already begun to form and could get damaged by smoking, alcohol, or drugs. If you need help quitting, speak with your doctor. There are effective treatments that can help.
Your partner should also stop smoking and using drugs. He should not drink too much alcohol.
Ask about risks
Ask your doctor what the risks to you and your baby might be if:
- You have any medical conditions– If you have a medical problem, it could cause problems for you or your baby during pregnancy. Women who have certain medical conditions should work with their doctor to get their conditions under control before they get pregnant. This includes women with diabetes, high blood pressure, asthma, thyroid conditions, seizure disorders, HIV infection, and other problems. If these conditions are not well controlled, they can cause problems for a mother and her baby during pregnancy.
- You or your partner has a family history of a medical condition– If you or your partner has a history of a condition that could be passed on to your baby, you might need genetic counselling. Genetic counselling can help you find out what the chances are that your baby will have the condition. It will also help you sort out what your options might be if your baby does have problems. Examples of conditions that might call for genetic counselling include cystic fibrosis, mental retardation, and muscular dystrophy.
Work on your weight
Women who weigh too little or too much can have problems getting pregnant and problems during pregnancy. You should try to reach a healthy weight before you try to get pregnant.
Down syndrome and fetal anomaly screening
Down syndrome screening during pregnancy
What is Down syndrome?
Down syndrome is a life-long condition that a person is born with. It can cause learning problems and medical problems affecting the heart, blood, digestive system, and other organs. The learning and medical problems in people with Down syndrome can be mild or severe.
People with Down syndrome have a problem with their chromosomes. Chromosomes are tiny parts of cells that carry the plans that make our bodies the way they are. People with Down syndrome have an extra chromosome. This causes their problems and makes them look a little different than people without Down syndrome.
About 1 in 700 babies is born with Down syndrome. A woman of any age can have a baby with Down syndrome. But a woman is more likely to have a baby with Down syndrome the older she gets. She’s also more likely to have a baby with Down syndrome if she has a close family member with the condition.
What are my options for Down syndrome testing during pregnancy?
During pregnancy, you can choose to have:
- Screening tests – These are tests that can tell you if it is likely that your baby has Down syndrome. But they do not tell you for sure.
- Diagnostic tests – These are tests that can tell you for sure if your baby has Down syndrome.
You can also choose not to have screening or diagnostic tests.
What do the screening tests involve?
Different screening tests are available depending on how far along a woman is in her pregnancy.
Screening tests can involve:
- Blood tests – Blood is taken from the mother.
- Ultrasound – This is an imaging test that creates pictures of the baby.
- Both blood tests and ultrasound
Having a screening test does not increase a woman’s chance of having a miscarriage. (A miscarriage is when a pregnancy ends on its own before the woman has been pregnant for 24 weeks.)
If a screening test shows that there is a high chance that a baby has Down syndrome, a woman can then have a diagnostic test to find out for sure.
What do the diagnostic tests involve?
Two types of diagnostic tests are available:
- Chorionic villus sampling, also called “CVS” – During CVS, a doctor removes a tiny piece of the placenta. The placenta is the organ that brings the baby nutrients and oxygen and carries away waste. CVS can be done by putting a thin tube through the vagina and into the uterus, or by inserting a needle through the woman’s belly. This test is usually done at 11 to 12 weeks of pregnancy, but it can be done as late as 14 weeks.
- Amniocentesis – During amniocentesis, a doctor puts a needle through the belly into the mother’s uterus and removes some of the fluid that is around the baby. This test is usually done between 15 and 20 weeks of pregnancy, but it can be done later.
It is important to know that diagnostic tests can have side effects. Women who have diagnostic tests have a small chance of having a miscarriage because of the test.
How do I decide whether or not to have tests?
This is a personal decision. If you are not sure what to choose, your doctor or nurse can talk to you about the benefits and downsides of the different options.
A woman might choose a screening test if she wants to understand whether her baby has a high or low chance of having Down syndrome. She might feel that she will worry less if there is a low chance that her baby has Down syndrome.
A woman might choose a diagnostic test if she wants to know for sure if her baby has Down syndrome. She might want the option to have an abortion, or she might want to continue with the pregnancy but have as much information as possible.
A woman might choose to have no tests if she feels that “whatever will be, will be.” She knows that she would not do anything differently no matter what the test results showed.
What happens after my test?
It depends on what kind of test you had.
If you had a screening test that showed that there is a high chance your baby has Down syndrome, you:
- Might be able to have another, different screening test, which can give you a better idea of how likely your baby is to have Down syndrome
- Can have a diagnostic test to know for sure if your baby has Down syndrome
- Not have any more tests done during pregnancy. You can wait until birth to have a test done to see if your baby has Down syndrome.
- Talk to an expert called a “genetic counsellor” to help you make a choice
If you had a diagnostic test that showed that your baby has Down syndrome for sure, your doctor will talk with you about what this means. If you continue with the pregnancy, you might choose to give birth in a hospital that has experience taking care of babies with Down syndrome. You can also learn more about Down syndrome so you have an idea of what to expect in the future.
General antenatal care
Antenatal care
What is antenatal care?
Prenatal care describes the medical care women get during their pregnancy. As part of your antenatal care, the doctor will:
- Figure out when your baby is due
- Talk to you about nutrition, physical activity, work, and common pregnancy complaints, such as morning sickness, heartburn, and backache
- Talk to you about things to avoid, such as alcohol, smoking, and some drugs and chemicals
- Monitor your health to watch for problems
- Monitor your baby’s health to check that he or she is growing well
- Talk with you about pregnancy, labour, and delivery, and make a plan for your labour and delivery
- Talk with you about taking care of yourself and your baby after the birth
- Do tests to check you and your baby for different health conditions
What happens at my first antenatal visit?
Your doctor will ask about your health and medical history, and figure out when your baby is due.
She will also do a general physical exam
She will also do tests that can include:
- A urine test
- Blood tests – Some blood tests check your general health. Other blood tests check for specific conditions that could cause problems for you or your baby.
- An ultrasound – An ultrasound uses sound waves to create pictures of the inside of your body and of your baby. This test is done to check your due date and see if you are pregnant with more than one baby.
What will happen at each prenatal visit?
The doctor will:
- Ask about your symptoms and answer any questions you have
- Check your blood pressure – Having high blood pressure can lead to problems, including a serious condition called “preeclampsia.”
- Check your weight – The amount of weight you should gain during pregnancy depends partly on what your weight was before you got pregnant.
- Measure the size of your uterus – Your uterus will get bigger as your pregnancy progresses.
- Listen for your baby’s heartbeat – The doctor or midwife will be able to hear your baby’s heartbeat starting at about 12 weeks of pregnancy.
- Test your urine to check for sugar or protein – Having sugar or protein in your urine might be a sign of a more serious problem.
- Ask about your baby’s movements – Women start feeling their baby move at different times. Most women feel their baby move by 20 to 25 weeks of pregnancy.
- Check your baby’s position in your uterus – In the last 2 or 3 months of pregnancy, the doctor will check your baby’s position at each visit.
What other tests are part of prenatal care?
Your doctor will order other tests during your pregnancy. These include routine tests that all pregnant women will have. They also include tests that some women choose to have.
Tests done during pregnancy can include:
- A test to check for diabetes (high blood sugar) – This involves drinking a sugar drink and then having your blood drawn.
- Blood tests to check for certain conditions or infections – These include tests to check your blood type and see if you have a condition called anaemia. They also include tests to check for infections that you could pass to your baby or that could harm your baby. Some of these infections are rubella, hepatitis B, and syphilis.
- An ultrasound – This test checks your placenta, the fluid around your baby, how your baby is growing, and how your baby’s organs are developing.
- Tests to check for birth defects or problems babies can be born with – For example, women can choose to test their baby for Down syndrome. Down syndrome is a life-long condition that causes medical and learning problems. Another common test is to check for spina bifida, a birth defect that involves the spine (backbone). If a disease runs in your family, your doctor can tell you whether your baby might be at risk.
How often will I see my doctor during pregnancy?
Your visits to your doctor will get more frequent as your pregnancy progresses. The schedule of visits is the following:
- Every 4 weeks until you are about 36 weeks pregnant
- Then every 2 weeks until you are about 38 weeks pregnant
- Then every week until delivery
Women with certain medical conditions (including conditions they had before they got pregnant) might need to see their doctor more often. They might also need other tests to follow their medical condition during pregnancy.
Delivery of your baby
Labour and delivery (childbirth)
What happens during labour?
Labour is the way a woman’s body prepares to give birth. This involves having contractions, which is when the uterus tightens. Contractions can be painful and make your belly feel hard. During labour, your cervix softens, thins out, and opens up or “dilates”. As you get closer to giving birth, your baby will move down from the uterus into the vagina. When this happens, it can feel like you are going to have a bowel movement.
Labour usually starts on its own between 37 and 42 weeks of pregnancy. In some cases, doctor will decide to “induce” labour. This usually involves giving you medicine to soften your cervix and start contractions. Doctor will only induce labour before 39 weeks if there is a medical reason. Usually, this means a situation where waiting to give birth could be dangerous for you or your baby.
What happens during delivery?
During delivery doctor will help you give birth to your baby. When a baby comes out of a woman’s vagina, it’s called a “vaginal delivery.” When a doctor does surgery to get a baby out of a woman’s uterus, it’s called a “C-section” or “caesarean delivery.”
During a vaginal delivery, once your cervix has opened all the way, you will work hard to push your baby out. The doctor will tell you when you can start pushing. In most cases, you can be in whatever position feels comfortable to you. For example, you can lie on your side, sit up, kneel, or squat. Pushing a baby out can take anywhere from minutes to hours. It usually takes longer when it’s a woman’s first baby.
Most mothers can push the baby out without any problems. But sometimes, the doctor will help get the baby out by pulling on a device that can be placed on the baby’s head. If the doctor needs to deliver a baby right away, he or she will do a Caesarean section.
Pain during childbirth
Childbirth usually hurts. Pain can come both from contractions and, later, from your vagina stretching as you push your baby out. But the amount of pain is different for each woman. Women choose to manage their pain in different ways. There is no one way that works for everyone. The right decision is the one that is best for you.
Some women choose to have a “natural” childbirth. This means that they do not use any pain medicines during labour or delivery. Instead, they do other things, such as breathing exercises, to lessen their pain.
Other women choose to have medicines to lessen the pain of labour and delivery. If you choose to have pain medicine, your doctor or midwife will probably start giving you the medicine during your labour, before delivery.
What if my baby is not in the right position?
Before birth, babies lie in the uterus in different positions. At the end of pregnancy, most babies lie with their head closest to the vagina. But some babies lie with their legs, buttocks, or shoulders closest to the vagina. Doctors call it “breech” if a baby’s legs or buttocks are closest to the vagina.
If your baby isn’t facing head down, your doctor will talk with you about your options.
What happens after I give birth?
After your baby is born, the doctor will clamp and cut the umbilical cord. Then they will give the baby to you, or to a paediatrician if the baby needs to be checked right away. If you and your baby are both healthy, the doctor might wait about a minute before they clamp the cord. This allows the baby to get some of the blood that is in the placenta. (The placenta is the organ inside the uterus that brings a baby nutrients and oxygen and carries away waste.)
Next, the placenta also needs to come out of the uterus. Usually the placenta comes out naturally within 30 minutes of the baby’s birth, but sometimes the doctor or midwife has to help remove it from the uterus.
After the placenta is out of your uterus, the doctor or midwife will examine your vagina. If your skin tore during birth, you might need some stitches.
What happens to my baby after birth?
After birth, the doctor, nurse, midwife, or paediatrician will do a quick exam to check your baby’s body and general health. Part of this exam is called an “Apgar test.” It checks your baby’s heart rate, breathing, movement, muscles, and skin colour. Your baby will get Apgar tests at 1 minute and 5 minutes after birth.
Soon after birth, you will be able to hold your baby. You can even breastfeed him or her, if you choose to breastfeed.
Your baby will get some treatments soon after birth. These include eye drops or an eye ointment to prevent an eye infection, and a dose of vitamin K to prevent abnormal bleeding.
Before your baby leaves the hospital, he or she will also have:
- A detailed physical exam
- A blood test (done by a heel prick) to check for different serious diseases that babies can be born with. For more information on this testing, ask your doctor or nurse.
- A hearing test
- A dose of the hepatitis B vaccine – Vaccines can prevent certain serious or deadly infections. Hepatitis B is a serious liver infection and other immunizations.
When should I call the doctor or nurse after a vaginal delivery?
After you leave the hospital, call the doctor if you:
- Bleed a lot from your vagina – It is normal to have some vaginal bleeding for a few weeks after delivery. But let your doctor or nurse know if you are having large blood clots or your bleeding increases.
- Feel dizzy or faint
- Get a fever
- Vomit
- Have new belly pain
- Have a severe headache or problems with your vision
- Feel sad or helpless
C-section (caesarean delivery)
What is a C-section?
A C-section is a type of surgery used for having a baby .If you have a C-section, you will be given anaesthesia so that you won’t feel pain. Then the doctor will make an incision in your belly and remove the baby from your uterus.
Will I know in advance if I need a C-section?
The most common reasons women have a caesarean delivery before they go into labour are:
- The mother had a baby by caesarean in the past
- The baby is not coming out head first
- The baby is very large
- The mother has an infection, such as herpes or HIV. These can spread to the baby during a vaginal birth.
- The mother has a condition called “placenta praevia.” In placenta previa, this organ blocks the way to the vagina.
- The baby has a problem, and the doctor believes labour and vaginal delivery might not be safe because of it.
Some women choose to have caesareans even if they don’t need to for medical reasons. You should talk to the doctor if you think you want to have your baby this way.
When should planned C-sections happen?
In most cases, you should wait until the 39th week of pregnancy or later. (A normal pregnancy lasts about 40 weeks.)
Why do some women end up having C-sections after labour begins?
A common reason is that labour doesn’t move along like it should. This can happen if:
- Contractions (the tightening of the uterus that happens during labour) are not strong enough to get the baby out
- The baby is too big
- The mother’s pelvis is too small
- The baby is in an odd position, like the head is sideways or chin-first
Other reasons that C-sections are done are:
- The baby’s life is in danger; for example, because its heart rate is too slow.
- The mother’s life is in danger; for example, because she is bleeding too much.
How is a C-section done?
Here are the main steps:
- First, you will get anaesthesia to keep you from feeling what happens during the surgery. There are 2 kinds of anaesthesia. With regional anesthesia, you stay awake. Under general anaesthesia, you are asleep.
- Next, the doctor will make an incision on your lower belly. There are 2 ways of making the incision:
- Most of the time, the incision goes across your belly, from 1 side to the other, an inch or 2 above your pubic hair.
- If you are bleeding a lot or your baby is in danger, the incision might go up and down. This kind of incision is sometimes the fastest way to get the baby out.
- After opening your belly, the doctor will make an opening in your uterus and remove the baby. Then the doctor will cut the umbilical cord and take out the placenta.
- Finally, the doctor will close your uterus and belly with stitches.
How long does it take to get better after the surgery?
Within a few hours, you will be able to move around, and eat and drink. Most women go home after 3 days, but will have some pain. It can take up to 6 weeks to heal completely. Women who have a job can usually go back to work after this time.
Are there risks of having a C-section?
Yes. Although most mothers and babies do well after a C-section, there are risks.
Compared with a vaginal delivery, C-sections are more likely to cause:
- Harm to the bladder, blood vessels, intestines, and other nearby organs
- Infection
- Blood clots that can block blood vessels and cause trouble breathing
- Lost bonding time between mother and baby
- A longer time for the mother to heal after the birth
- Problems with the placenta and uterus in later pregnancies
- Trouble breathing for the newborn. This usually lasts for just a short time.
Your doctor can help you decide if the risks of surgery are worth taking for you.
What symptoms will I have while I’m getting better?
For the first few weeks, it is common to have:
- Mild cramps in your belly
- Light bleeding and yellowish fluids coming out of your vagina
- Pain where the incision was made
Call your doctor if:
- You have a fever higher than 38°C
- Your pain gets worse
- Your vaginal bleeding gets heavier
- The incision in your belly gets more sore or red, or is bleeding or leaking fluid
Postnatal care
Specific medical conditions and possible complications will be assessed and on-going medical and contraceptive needs will be addressed.
The L'Jab
The L’Jab is a 20 minute, non-surgical procedure. It begins with a simple blood draw. Then, using proprietary techniques, platelet rich plasma is extracted from the blood and injected into the numbed area near the clitoris and upper vagina to enhance sexual pleasure.
Up to 25% of women have an orgasmic dysfunction, and there are few products on the market that are designed to help. The L’Jab, is a non-surgical procedure that can stimulate the vagina in a way that positively impacts orgasms.
Because the platelet rich plasma (P.R.P) contains growth hormone factors, it rejuvenates the vagina treating also urinary stress/urge incontinence, looseness, dryness or lack of sensitivity.
There is no recovery time and results are almost immediate in some women. The effect of Genital P.R.P heightens about 3 weeks after the injection and the full effect ramps up by the third month. The effect of the injection lasts for about 8-12 months.
Almost anyone can get L’Jab but Dr Leneque Lindeque will help you determine if this is the best procedure for you. Women both on and off hormone replacement therapy can usually benefit from this procedure.
Labiaplasty
Inner Lips (Labia Minora)
This Labiaplasty procedure is designed to alter the shape and size of the labia minora, or inner lips of the vagina with surgery. This procedure is indicated for women with asymmetrical or larger lips or those concerned about dark skin tones and unsightly genitalia. This can also be a concern for women who have a lack of self-confidence due to the appearance of their inner lips which could then affect sexual performance and enjoyment.
Outer Lips (Labia Majora)
This Labiaplasty procedure focuses on altering the shape and size of the labia majora (exterior vaginal lips) by removing the excess fat and tightening or lifting relaxed skin present there.
Almost anyone can get Labiaplasty but Dr Leneque Lindeque will help you determine if this is the best procedure for you.
Vaginoplasty
Vaginoplasty is a general term for any procedure that reshapes the vagina. These include cosmetic and therapeutic operations of both the opening, known as the introitus, and the canal of the vagina. This procedure is usually necessary in women whose vagina’s have been damaged or changed shape after childbirth or with aging.
The Vaginoplasty procedure involves bringing the pelvic floor muscles closer together, removal of any loose skin or scar tissue or a combination of these procedures. The end result is a neater and reconstructed vagina that will improve the functionality and pleasure during sexual relations.
Almost anyone can get a Vaginoplasty but Dr Leneque Lindeque will help you determine if this is the best procedure for you.
Vaginal Laser Rejuvenation
Your vaginal laser rejuvenation at FemRegenX takes less than 30 minutes. Life processes such as childbirth, weight fluctuations and hormonal changes may overstretch and damage vaginal tissue, damage the pelvic floor and alter the mucosal tone of the vaginal wall.
Vaginal laser rejuvenation is virtually painless and has no side effects. A single-use probe is inserted into the vagina in the consulting rooms and is rotated as the laser is applied to the vaginal tissue.
A state-of-the-art, minimally-invasive outpatient solution that incorporates CO2 technology to provide optimal care for various feminine concerns. The procedure is fast, painless and completely safe, and provides highly effective results. Procedures are conducted in an outpatient setting, and do not require anaesthesia or downtime, ensuring that women can resume their routine – and regain their confidence – soon after.
Dr Lindeque offers a versatile and wide range of solution that enable her to treat feminine indications and boost women’s wellness quickly and effectively.
Almost anyone can get vaginal laser rejuvenation but Dr Leneque Lindeque will help you determine if this is the best procedure for you.
Intimate Area Bleaching
Intimate Area Bleaching, will correct Vulvar hyper pigmentation or darkening of the skin caused by an increased concentration of melanin, which can occur in response to certain medical conditions, medications, and physical irritation. It can affect self-confidence and also sexual health.
While it could be seen as a superficial, perhaps unnecessary procedure, darkened skin can have a hugely negative impact on women’s confidence. “Genital bleaching allows women to regain confidence they may have lost due to darkening genital skin.
Treatments include the application of various chemicals that lighten and soften the affected area, lightening peels to resurface the skin, and the latest generation fractional CO2 laser or a combination of the above.
The Intimate Area Bleaching procedure takes place over three or more sessions (depending on the severity) of laser therapy lasting 10 to 15 minutes per session. This procedure is done in the consulting rooms and is performed using local anaesthetics. The laser therapy can then be augmented by chemical treatments and home-use application creams.
Almost anyone can get a Intimate Area Bleaching but Dr Leneque Lindeque will help you determine if this is the best procedure for you.
Aesthetic Services
Dr Leneque Lindeque is a female
Obstetrician & Aesthetic Gynaecologist
based in Hilton. Visit her practice at
Suite 4B, First Floor, Hilton Health
3 Monzali Drive, Hilton Gardens, Hilton
Annual gynae checkup
About Annual Exams
For many women, the thought of attending an annual gynaecological exam can bring up feelings of embarrassment or anxiety, which, unfortunately, may lead to avoidance. Some women choose not to visit their gynaecologist for modesty reasons or possibly because they are worried something may be wrong. In reality, annual gynaecological exams are incredibly important for all women.
The benefits of annual exams far outweigh the dread that many women experience. We’ll discuss why gynaecological exams are needed, what to expect during your exam, and why it’s essential to get them on a yearly basis.
Annual gynaecological exams are often referred to as “well women exams,” or “well women check-ups,” to help reassure and reduce any anxiety caused by going to the gynaecologist. The American College of Obstetrics and Gynaecology recommends yearly visits for annual exams.
When to get annual gynaecological exams?
- Typically, the first annual exam should occur between the ages of 13 to 15. Pelvic exams are usually not required during these first visits.
- Around the age of 19, many annual exams will include pelvic exams and also check for breast and abdominal issues.
- Pap smear testing begins at age 21.
Some women may feel that you’re only supposed to go to an annual exam to collect a pap smear, which isn’t entirely true. While many women will receive a pap smear at three or five-year intervals, gynaecological exams check for more and offer an appropriate time for you to discuss any changes, experiences, or concerns about your gynaecological health. These exams also provide an excellent time to check for preventable diseases such as cervical cancer. The risk of cervical cancer does decrease with age, but as women get older, they often have an increased risk for other cancers like uterine, ovarian, and breast cancer—all of which an annual exam can assess.
Exam Expectations
During an annual exam, you’ll have a comprehensive medical history taken to assess any potential risk for familial cancer and other hereditary health issues. You will also have a physical exam performed which checks vital stats like blood pressure, height, and weight. Depending upon the age of the patient, there will be a pelvic exam, and a breast exam conducted, as well as, evaluation of symptoms, screenings, and counselling. Furthermore, if a patient is sexually active, a provider may test for common sexually transmitted diseases like chlamydia, gonorrhoea, and HIV.
Counselling is an integral part of an annual exam. It’s crucial to be as honest as possible with your provider so that they can help with any issues that arise. While talking with your provider, they may address other topics such as:
- Nutrition
- Physical Activity
- Sexual Practices
- Sexually Transmitted Diseases
- Menstrual Cycle
- Pregnancy
- Contraceptives
- Hormones
- Urinary Symptoms
- Pelvic Symptoms
- Menopause Symptoms
- Screenings (cholesterol, diabetes, thyroid, colonoscopy, mammograms, etc.)
- Mental Health
- Vaccinations
- Tobacco Use
- Alcohol Use
- Drug Use
- Other Health Issues
5 Reasons Why Annual Exams are Important
Without an annual exam, patients run the risk of developing gynaecological health and pelvic-related issues that could have either been prevented or stopped early-on, so they don’t turn into a more significant problem. Here are five reasons why it’s incredibly important to have your yearly check-up with your OBGYN.
- Promote Patient-Provider Relations: Annual exams help promote provider-patient relationships where women can discuss reproductive development, menstrual cycles, and ways to prevent pregnancy, prenatal care, and family planning. It’s especially important for patients to feel comfortable discussing anything with their OBGYN.
- Easy Shift in Care: Forming that bond with a patient-provider means that when you’re ready to make the shift from preventive care to prenatal care and family planning, you’ll already have that relationship developed and you’ll know you’ll be in good hands.
- Product Innovation: Attending your annual exam means you’ll be in-the-know about new gynaecological innovations. With technology evolving at a fast pace, you’ll be able to learn about new diagnostic tests, preventative measures, and contraceptives such as permanent birth control which leaves you with more options to choose from when it comes to your body and your health.
- Update Your Health:Annual exams allow patients to catch up on vaccines missed during childhood or have additional screenings conducted to check for various health conditions. Plus, they are a good way for you to know what’s going on with your gynaecological health.
- Prevent Future Issues:We hear stories all the time about preventative screenings saving someone’s life, and it might just be yours. Annual exams check for symptoms such as unusual bleeding or vaginal discharge which may be signs of a disease in a later stage. With a myriad of preventative screenings and tests you’ll be able to take charge of your health by, hopefully, preventing a serious disease.
Is for sure—you should schedule your annual exam before it’s too late!
Family planning & contraception
Family Planning
If you want to have a baby, it is important to prepare for pregnancy, not simply “go off your birth control method.” The way each woman prepares will be different; some may need to change medications, and others may need to stop smoking. Others may need to significantly increase their intake of folic acid.
Even if a woman is considered healthy, she should still schedule a consultation with her gynecologist to help ensure she and her baby will be as healthy as possible.
For some women, preparing for pregnancy can take a few months or longer, and therefore it is important to consult with your gynecologist prior to going off your birth control. Remember to include your partner in this family planning process, too.
Contraception Counseling
When it comes to contraception, there are many options to choose from and each have their pluses and minuses. While you likely already know about birth control pills and condoms, there are other options you might not know as much about that could be good choices for you.
Our physicians can counsel you on the pros and cons of each option, taking into consideration your overall health, your lifestyle and habits, and other factors.
Variety of Options Available
Prior to your appointment at our center, you may want to learn the basics about the range of choices available to you. Below are descriptions of types of contraception you may want to consider:
Hormonal Contraception Options
Hormonal methods prevent pregnancy by preventing ovulation.
- Birth Control Pill: An oral contraceptive that is taken every day
- Contraceptive Patch: A thin, flexible patch that you adhere to on your upper outer arm, buttocks, stomach or back every three weeks
- Vaginal Contraceptive Ring: A thin, flexible ring that is inserted into your vagina and left for three weeks
- Hormone Shots: A hormone shot that is typically injected in your arm every three months
- Hormone Implant: A thin, flexible piece of plastic that is inserted into your upper arm. One implant prevents pregnancy for up to 3 years, but your doctor can remove the implant at any time.
- Intrauterine Device (IUD): A small, T-shaped device with a string attached. The IUD is placed the uterus during a visit to our office and remains there until we remove it.
Barrier Contraception Options
Barrier methods work by blocking sperm from the uterus.
- Spermicide: A substance that stops sperm from moving
- Diaphragm: A dome-shaped cup that fits over the opening of the uterus and is used with spermicide. Your physician will determine the correct size and fit for you.
- Cervical Cap: A silicone cup that is inserted into the vagina and fits over the cervix. Your physician will determine which size you need.
- Contraceptive Sponge: A small foam sponge that contains spermicide. It is inserted into the vagina and covers the cervix. You do not need a prescription for the sponge.
- Condoms: A latex sheath that fits over a man’s penis and traps semen. It is safest when used with other methods of birth control, such as a spermicide.
- Female condoms: A pouch made of thin rubber that includes a ring on each end. It is inserted into the vagina before sexual activity.
Other Contraception Options
- Sterilization: Surgery to permanently prevent pregnancy by closing off the Fallopian tubes so eggs can’t travel through them to reach the uterus
- Natural Family Planning: Requires a couple to learn when a woman can get pregnant during her cycle and avoid intercourse during those days
- Emergency Contraception: Birth control, informally known as “the morning after pill,” that prevents pregnancy after sexual intercourse
Menopause
Menopause happens when you haven’t had a period for 12 straight months and you aren’t pregnant or sick. It’s a normal part of aging. It happens because female sex hormone levels naturally go down as you get older. Your ovaries eventually stop releasing eggs, so you’ll no longer have periods or be able to get pregnant.Most women go through menopause in their 40’s or 50’s.
But that can vary widely. One study found that half of the women in the U.S. reach menopause before about age 52. Some women may go through “the change” earlier if they’ve had surgery to remove their uterus or ovaries or are having certain treatments for cancer.
Are You Headed for Menopause?
You may start to notice changes months or years before you are in menopause. You may have hot flashes and irregular periods. This time is called perimenopause.
You won’t know exactly when your menopause will hit. All you can do is pay attention to how you’re feeling and notice changes. Keep in mind that symptoms vary greatly from woman to woman. Some women have no symptoms at all.
Menstrual irregularities
What is abnormal menstruation?
Most women have menstrual periods that last four to seven days. A woman’s period usually occurs every 28 days, but normal menstrual cycles can range from 21 days to 35 days.
Examples of menstrual problems include:
- Periods that occur less than 21 days or more than 35 days apart
- Missing three or more periods in a row
- Menstrual flow that is much heavier or lighter than usual
- Periods that last longer than seven days
- Periods that are accompanied by pain, cramping, nausea or vomiting
- Bleeding or spotting that happens between periods, after menopause or following sex
Examples of abnormal menstruation include the following:
- Amenorrhea is a condition in which a woman’s periods have stopped completely. The absence of a period for 90 days or more is considered abnormal unless a woman is pregnant, breastfeeding, or going through menopause (which generally occurs for women between ages 45 and 55). Young women who haven’t started menstruating by age 15 or 16 or within three years after their breasts begin to develop are also considered to have amenorrhea.
- Oligomenorrhea refers to periods that occur infrequently.
- Dysmenorrhea refers to painful periods and severe menstrual cramps. Some discomfort during the cycle is normal for most women.
- Abnormal uterine bleeding may apply to a variety of menstrual irregularities, including: a heavier menstrual flow; a period that lasts longer than seven days; or bleeding or spotting between periods, after sex, or after menopause.
What causes abnormal menstruation (periods)?
There are many causes of abnormal periods, ranging from stress to more serious underlying medical conditions:
- Stress and lifestyle factors. Gaining or losing a significant amount of weight, dieting, changes in exercise routines, travel, illness, or other disruptions in a woman’s daily routine can have an impact on her menstrual cycle.
- Birth control pills. Most birth control pills contain a combination of the hormones estrogen and progestin (some contain progestin alone). The pills prevent pregnancy by keeping the ovaries from releasing eggs. Going on or off birth control pills can affect menstruation. Some women have irregular or missed periods for up to six months after discontinuing birth control pills. This is an important consideration when you are planning on conception and becoming pregnant. Women who take birth control pills that contain progestin only may have bleeding between periods.
- Uterine polyps or fibroids. Uterine polyps are small benign (noncancerous) growths in the lining of the uterus. Uterine fibroids are tumors that attach to the wall of the uterus. There may be one or several fibroids that range from as small as an apple seed to the size of a grapefruit. These tumors are usually benign, but they may cause heavy bleeding and pain during periods. If the fibroids are large, they might put pressure on the bladder or rectum, causing discomfort.
- Endometriosis. The endometrial tissue that lines the uterus breaks down every month and is discharged with the menstrual flow. Endometriosis occurs when the endometrial tissue starts to grow outside the uterus. Often, the endometrial tissue attaches itself to the ovaries or fallopian tubes; it sometimes grows on the intestines or other organs in the lower digestive tract and in the area between your rectum and uterus. Endometriosis may cause abnormal bleeding, cramps or pain before and during periods, and painful intercourse.
- Pelvic inflammatory disease. Pelvic inflammatory disease (PID) is a bacterial infection that affects the female reproductive system. Bacteria may enter the vagina via sexual contact and then spread to the uterus and upper genital tract. Bacteria might also enter the reproductive tract via gynecologic procedures or through childbirth, miscarriage, or abortion. Symptoms of PID include a heavy vaginal discharge with an unpleasant odor, irregular periods, pain in the pelvic and lower abdominal areas, fever, nausea, vomiting, or diarrhea.
- Polycystic ovary syndrome. In polycystic ovary syndrome (PCOS), the ovaries make large amounts of androgens, which are male hormones. Small fluid-filled sacs (cysts) may form in the ovaries. These can often been seen on an ultrasound. The hormonal changes can prevent eggs from maturing, and so ovulation may not take place consistently. Sometimes a woman with polycystic ovary syndrome will have irregular periods or stop menstruating completely. In addition, the condition is associated with obesity, infertility and hirsutism (excessive hair growth and acne). This condition may be caused by a hormonal imbalance, although the exact cause is unknown. Treatment of PCOS depends on whether a woman desires pregnancy. If pregnancy is not a goal, then weight loss, oral contraceptive pills, and the medication Metformin® (an insulin sensitizer used in diabetes) can regulate a woman’s cycles. If pregnancy is desired, ovulation-stimulating medications can be tried.
- Premature ovarian insufficiency. This condition occurs in women under age 40 whose ovaries do not function normally. The menstrual cycle stops, similar to menopause. This can occur in patients who are being treated for cancer with chemotherapy and radiation, or if you have a family history of premature ovarian insufficiency or certain chromosomal abnormalities. If this condition occurs, see your physician.
Other causes of abnormal menstruation include:
- Uterine cancer or cervical cancer
- Medications, such as steroids or anticoagulant drugs (blood thinners)
- Medical conditions, such as bleeding disorders, an under- or overactive thyroid gland, or pituitary disorders that affect hormonal balance
- Complications associated with pregnancy, including miscarriage or an ectopic pregnancy (the fertilized egg is implanted outside the uterus; for example, within the fallopian tube)
How is abnormal menstruation (periods) diagnosed?
If any aspect of your menstrual cycle has changed, you should keep an accurate record of when your period begins and ends, including the amount of flow and whether you pass large blood clots. Keep track of any other symptoms, such as bleeding between periods and menstrual cramps or pain.
Your doctor will ask you about your menstrual cycle and medical history. He or she will perform a physical examination, including a pelvic exam and sometimes a Pap test. The doctor might also order certain tests, including the following:
- Blood tests to rule out anemia or other medical disorders
- Vaginal cultures, to look for infections
- A pelvic ultrasound exam to check for uterine fibroids, polyps or an ovarian cyst
- An endometrial biopsy, in which a sample of tissue is removed from the lining of the uterus, to diagnose endometriosis, hormonal imbalance, or cancerous cells. Endometriosis or other conditions may also be diagnosed using a procedure called a laparoscopy, in which the doctor makes a tiny incision in the abdomen and then inserts a thin tube with a light attached to view the uterus and ovaries
Polycysitic ovarian syndrome management
Management & treatment
Management and treatment of PCOS can include a range of elements such as a healthy approach to diet and physical activity, medications and complementary therapies. The following information is a general introduction to the different ways you can manage and treat PCOS.
There are a number of ways to manage the symptoms and the impact of PCOS, so after diagnosis it is important to seek help as soon as you can.
The keys to managing PCOS well include:
- A good understanding of how it’s caused and the effect of PCOS on the body
- A healthy approach to eating and physical activity
- Appropriate medical therapies
Managing PCOS with lifestyle
A healthy lifestyle is one of the most important aspects of managing PCOS successfully.
A healthy diet will ensure you are getting an adequate intake of nutrients, vitamins and minerals.
Loss of excess weight may reduce the severity of some symptoms and will reduce the risk of developing type 2 diabetes and cardiovascular disease.
Even a 5-10% weight loss can have significant health benefits, including improved mood and fertility, more regular menstrual cycles and a reduced risk of diabetes.
Physical activity
Being physically active increases energy levels, helps with self-confidence and motivation and reduces anxiety and depression.
While every bit of physical activity helps, the guidelines recommend that women with PCOS exercise at least 150 minutes per week, of which 90 minutes should be aerobic activity at moderate to high intensity (60-90% of maximum heart rate).
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Managing PCOS with medical therapies
There are a number of different medical therapies used to manage the different symptoms of PCOS, including for periods, fertility, excess hair, acne and weight
These therapies may include:
- the oral contraceptive pill
- insulin sensitising drugs such as Metformin
- hormones that are called gonadotrophins
- testosterone lowering drugs
- weight loss drugs
- antidepressants
- anti-anxiety drugs.
Prenatal assessment
How to plan and prepare for a healthy pregnancy.
Should I see a doctor before I try to get pregnant?
Yes. It’s very important that you see your doctor or nurse for a “pre-pregnancy check-up.” Your doctor will ask you about things that could affect your pregnancy. For instance, he or she might ask about your diet, lifestyle, use of birth control, past pregnancies, medicines, and any diseases that you have or that run in your family.
There are several things that you and your doctor or nurse can do to make sure that your pregnancy is as healthy as possible. These things should be done before you try to get pregnant:
- Discuss any medicines or herbal drugs you take and find out if you need to make changes
- Discuss whether you are up-to-date on your vaccines
- Start taking a multivitamin that has folic acid(also called folate)
- Know which foods you should avoid and which foods are best
- Stop smoking, drinking alcohol, or taking drugs not prescribed for you by a doctor
- Understand the risks to you and your baby if:
- You have any medical conditions
- There are diseases that run in your family or your partner’s family
- Try to reach a healthy weight
Ask if the medicines you take are safe
If you take any medicines, supplements, or herbal drugs, ask your doctor if it is safe to keep taking them while you are pregnant or trying to get pregnant. Some medicines take a long time to leave your body completely, so it’s important to plan ahead. In some cases, your doctor and nurse will want you to switch to different medicines that are safer for the baby. Your doctor might need to slowly get you off some medicines because it could harm you to stop them all of a sudden. This is especially important for women who take medicines to treat seizures, high blood pressure, lupus, and rheumatoid arthritis.
Check if you need any vaccines
Women who want to get pregnant should be up-to-date on their vaccines. This includes vaccines against measles, mumps, rubella, tetanus, diphtheria, polio, chickenpox (also called varicella), and possibly hepatitis. Many women got these vaccines as children. Still, it is important to check that you have had all the right vaccines. Otherwise, you could get sick with the diseases the vaccines protect against, and that could cause problems for you or your baby. All women should also get a flu shot every year.
Some vaccines cannot be given during pregnancy or in the month before pregnancy. It’s important to get these vaccines more than a month before you start trying to get pregnant.
Start taking a multivitamin
If you want to get pregnant, take a “prenatal” multivitamin every day that has at least 400 micrograms of folic acid. This helps prevent some birth defects. Start taking the multivitamin at least a month before you start trying to get pregnant. It’s not enough to start taking vitamins when you find out you are pregnant. At that point, your baby has already formed many body parts that rely on folic acid and other vitamins to develop normally.
It is important not to take too much of any vitamin during pregnancy, especially vitamin A. Show your doctor the vitamins you plan to take to make sure the doses are safe for you and your baby.
Check your diet
Some foods are not safe for a woman who is pregnant or trying to get pregnant. If you are trying to get pregnant, do not eat raw or undercooked meat. Avoid eating shark, swordfish, king mackerel, or tilefish because they can have high levels of mercury. Check with your doctor or nurse about the safety of fish caught in local rivers and lakes. Limit the amount of caffeine you have by not drinking more than 1 or 2 cups of coffee each day. Tea and cola also contain caffeine, but usually not as much as coffee. Try to eat a balanced diet rich in fruits, vegetables, and whole grains. Wash fruits and vegetables before eating them.
Stop smoking, drinking alcohol, or taking illegal drugs
If you smoke, drink alcohol, or take drugs not prescribed for you by a doctor, now more than ever it is important that you stop. Even small amounts of these substances from time to time during pregnancy could hurt your baby. This includes electronic cigarettes (“vaping”) or marijuana.
It’s not enough to stop as soon as you find out you are pregnant. By then the baby has already begun to form and could get damaged by smoking, alcohol, or drugs. If you need help quitting, speak with your doctor. There are effective treatments that can help.
Your partner should also stop smoking and using drugs. He should not drink too much alcohol.
Ask about risks
Ask your doctor what the risks to you and your baby might be if:
- You have any medical conditions– If you have a medical problem, it could cause problems for you or your baby during pregnancy. Women who have certain medical conditions should work with their doctor to get their conditions under control before they get pregnant. This includes women with diabetes, high blood pressure, asthma, thyroid conditions, seizure disorders, HIV infection, and other problems. If these conditions are not well controlled, they can cause problems for a mother and her baby during pregnancy.
- You or your partner has a family history of a medical condition– If you or your partner has a history of a condition that could be passed on to your baby, you might need genetic counselling. Genetic counselling can help you find out what the chances are that your baby will have the condition. It will also help you sort out what your options might be if your baby does have problems. Examples of conditions that might call for genetic counselling include cystic fibrosis, mental retardation, and muscular dystrophy.
Work on your weight
Women who weigh too little or too much can have problems getting pregnant and problems during pregnancy. You should try to reach a healthy weight before you try to get pregnant.
Down syndrome and fetal anomaly screening
Down syndrome screening during pregnancy
What is Down syndrome?
Down syndrome is a life-long condition that a person is born with. It can cause learning problems and medical problems affecting the heart, blood, digestive system, and other organs. The learning and medical problems in people with Down syndrome can be mild or severe.
People with Down syndrome have a problem with their chromosomes. Chromosomes are tiny parts of cells that carry the plans that make our bodies the way they are. People with Down syndrome have an extra chromosome. This causes their problems and makes them look a little different than people without Down syndrome.
About 1 in 700 babies is born with Down syndrome. A woman of any age can have a baby with Down syndrome. But a woman is more likely to have a baby with Down syndrome the older she gets. She’s also more likely to have a baby with Down syndrome if she has a close family member with the condition.
What are my options for Down syndrome testing during pregnancy?
During pregnancy, you can choose to have:
- Screening tests – These are tests that can tell you if it is likely that your baby has Down syndrome. But they do not tell you for sure.
- Diagnostic tests – These are tests that can tell you for sure if your baby has Down syndrome.
You can also choose not to have screening or diagnostic tests.
What do the screening tests involve?
Different screening tests are available depending on how far along a woman is in her pregnancy.
Screening tests can involve:
- Blood tests – Blood is taken from the mother.
- Ultrasound – This is an imaging test that creates pictures of the baby.
- Both blood tests and ultrasound
Having a screening test does not increase a woman’s chance of having a miscarriage. (A miscarriage is when a pregnancy ends on its own before the woman has been pregnant for 24 weeks.)
If a screening test shows that there is a high chance that a baby has Down syndrome, a woman can then have a diagnostic test to find out for sure.
What do the diagnostic tests involve?
Two types of diagnostic tests are available:
- Chorionic villus sampling, also called “CVS” – During CVS, a doctor removes a tiny piece of the placenta. The placenta is the organ that brings the baby nutrients and oxygen and carries away waste. CVS can be done by putting a thin tube through the vagina and into the uterus, or by inserting a needle through the woman’s belly. This test is usually done at 11 to 12 weeks of pregnancy, but it can be done as late as 14 weeks.
- Amniocentesis – During amniocentesis, a doctor puts a needle through the belly into the mother’s uterus and removes some of the fluid that is around the baby. This test is usually done between 15 and 20 weeks of pregnancy, but it can be done later.
It is important to know that diagnostic tests can have side effects. Women who have diagnostic tests have a small chance of having a miscarriage because of the test.
How do I decide whether or not to have tests?
This is a personal decision. If you are not sure what to choose, your doctor or nurse can talk to you about the benefits and downsides of the different options.
A woman might choose a screening test if she wants to understand whether her baby has a high or low chance of having Down syndrome. She might feel that she will worry less if there is a low chance that her baby has Down syndrome.
A woman might choose a diagnostic test if she wants to know for sure if her baby has Down syndrome. She might want the option to have an abortion, or she might want to continue with the pregnancy but have as much information as possible.
A woman might choose to have no tests if she feels that “whatever will be, will be.” She knows that she would not do anything differently no matter what the test results showed.
What happens after my test?
It depends on what kind of test you had.
If you had a screening test that showed that there is a high chance your baby has Down syndrome, you:
- Might be able to have another, different screening test, which can give you a better idea of how likely your baby is to have Down syndrome
- Can have a diagnostic test to know for sure if your baby has Down syndrome
- Not have any more tests done during pregnancy. You can wait until birth to have a test done to see if your baby has Down syndrome.
- Talk to an expert called a “genetic counsellor” to help you make a choice
If you had a diagnostic test that showed that your baby has Down syndrome for sure, your doctor will talk with you about what this means. If you continue with the pregnancy, you might choose to give birth in a hospital that has experience taking care of babies with Down syndrome. You can also learn more about Down syndrome so you have an idea of what to expect in the future.
General antenatal care
Antenatal care
What is antenatal care?
Prenatal care describes the medical care women get during their pregnancy. As part of your antenatal care, the doctor will:
- Figure out when your baby is due
- Talk to you about nutrition, physical activity, work, and common pregnancy complaints, such as morning sickness, heartburn, and backache
- Talk to you about things to avoid, such as alcohol, smoking, and some drugs and chemicals
- Monitor your health to watch for problems
- Monitor your baby’s health to check that he or she is growing well
- Talk with you about pregnancy, labour, and delivery, and make a plan for your labour and delivery
- Talk with you about taking care of yourself and your baby after the birth
- Do tests to check you and your baby for different health conditions
What happens at my first antenatal visit?
Your doctor will ask about your health and medical history, and figure out when your baby is due.
She will also do a general physical exam
She will also do tests that can include:
- A urine test
- Blood tests – Some blood tests check your general health. Other blood tests check for specific conditions that could cause problems for you or your baby.
- An ultrasound – An ultrasound uses sound waves to create pictures of the inside of your body and of your baby. This test is done to check your due date and see if you are pregnant with more than one baby.
What will happen at each prenatal visit?
The doctor will:
- Ask about your symptoms and answer any questions you have
- Check your blood pressure – Having high blood pressure can lead to problems, including a serious condition called “preeclampsia.”
- Check your weight – The amount of weight you should gain during pregnancy depends partly on what your weight was before you got pregnant.
- Measure the size of your uterus – Your uterus will get bigger as your pregnancy progresses.
- Listen for your baby’s heartbeat – The doctor or midwife will be able to hear your baby’s heartbeat starting at about 12 weeks of pregnancy.
- Test your urine to check for sugar or protein – Having sugar or protein in your urine might be a sign of a more serious problem.
- Ask about your baby’s movements – Women start feeling their baby move at different times. Most women feel their baby move by 20 to 25 weeks of pregnancy.
- Check your baby’s position in your uterus – In the last 2 or 3 months of pregnancy, the doctor will check your baby’s position at each visit.
What other tests are part of prenatal care?
Your doctor will order other tests during your pregnancy. These include routine tests that all pregnant women will have. They also include tests that some women choose to have.
Tests done during pregnancy can include:
- A test to check for diabetes (high blood sugar) – This involves drinking a sugar drink and then having your blood drawn.
- Blood tests to check for certain conditions or infections – These include tests to check your blood type and see if you have a condition called anaemia. They also include tests to check for infections that you could pass to your baby or that could harm your baby. Some of these infections are rubella, hepatitis B, and syphilis.
- An ultrasound – This test checks your placenta, the fluid around your baby, how your baby is growing, and how your baby’s organs are developing.
- Tests to check for birth defects or problems babies can be born with – For example, women can choose to test their baby for Down syndrome. Down syndrome is a life-long condition that causes medical and learning problems. Another common test is to check for spina bifida, a birth defect that involves the spine (backbone). If a disease runs in your family, your doctor can tell you whether your baby might be at risk.
How often will I see my doctor during pregnancy?
Your visits to your doctor will get more frequent as your pregnancy progresses. The schedule of visits is the following:
- Every 4 weeks until you are about 36 weeks pregnant
- Then every 2 weeks until you are about 38 weeks pregnant
- Then every week until delivery
Women with certain medical conditions (including conditions they had before they got pregnant) might need to see their doctor more often. They might also need other tests to follow their medical condition during pregnancy.
Delivery of your baby
Labour and delivery (childbirth)
What happens during labour?
Labour is the way a woman’s body prepares to give birth. This involves having contractions, which is when the uterus tightens. Contractions can be painful and make your belly feel hard. During labour, your cervix softens, thins out, and opens up or “dilates”. As you get closer to giving birth, your baby will move down from the uterus into the vagina. When this happens, it can feel like you are going to have a bowel movement.
Labour usually starts on its own between 37 and 42 weeks of pregnancy. In some cases, doctor will decide to “induce” labour. This usually involves giving you medicine to soften your cervix and start contractions. Doctor will only induce labour before 39 weeks if there is a medical reason. Usually, this means a situation where waiting to give birth could be dangerous for you or your baby.
What happens during delivery?
During delivery doctor will help you give birth to your baby. When a baby comes out of a woman’s vagina, it’s called a “vaginal delivery.” When a doctor does surgery to get a baby out of a woman’s uterus, it’s called a “C-section” or “caesarean delivery.”
During a vaginal delivery, once your cervix has opened all the way, you will work hard to push your baby out. The doctor will tell you when you can start pushing. In most cases, you can be in whatever position feels comfortable to you. For example, you can lie on your side, sit up, kneel, or squat. Pushing a baby out can take anywhere from minutes to hours. It usually takes longer when it’s a woman’s first baby.
Most mothers can push the baby out without any problems. But sometimes, the doctor will help get the baby out by pulling on a device that can be placed on the baby’s head. If the doctor needs to deliver a baby right away, he or she will do a Caesarean section.
Pain during childbirth
Childbirth usually hurts. Pain can come both from contractions and, later, from your vagina stretching as you push your baby out. But the amount of pain is different for each woman. Women choose to manage their pain in different ways. There is no one way that works for everyone. The right decision is the one that is best for you.
Some women choose to have a “natural” childbirth. This means that they do not use any pain medicines during labour or delivery. Instead, they do other things, such as breathing exercises, to lessen their pain.
Other women choose to have medicines to lessen the pain of labour and delivery. If you choose to have pain medicine, your doctor or midwife will probably start giving you the medicine during your labour, before delivery.
What if my baby is not in the right position?
Before birth, babies lie in the uterus in different positions. At the end of pregnancy, most babies lie with their head closest to the vagina. But some babies lie with their legs, buttocks, or shoulders closest to the vagina. Doctors call it “breech” if a baby’s legs or buttocks are closest to the vagina.
If your baby isn’t facing head down, your doctor will talk with you about your options.
What happens after I give birth?
After your baby is born, the doctor will clamp and cut the umbilical cord. Then they will give the baby to you, or to a paediatrician if the baby needs to be checked right away. If you and your baby are both healthy, the doctor might wait about a minute before they clamp the cord. This allows the baby to get some of the blood that is in the placenta. (The placenta is the organ inside the uterus that brings a baby nutrients and oxygen and carries away waste.)
Next, the placenta also needs to come out of the uterus. Usually the placenta comes out naturally within 30 minutes of the baby’s birth, but sometimes the doctor or midwife has to help remove it from the uterus.
After the placenta is out of your uterus, the doctor or midwife will examine your vagina. If your skin tore during birth, you might need some stitches.
What happens to my baby after birth?
After birth, the doctor, nurse, midwife, or paediatrician will do a quick exam to check your baby’s body and general health. Part of this exam is called an “Apgar test.” It checks your baby’s heart rate, breathing, movement, muscles, and skin colour. Your baby will get Apgar tests at 1 minute and 5 minutes after birth.
Soon after birth, you will be able to hold your baby. You can even breastfeed him or her, if you choose to breastfeed.
Your baby will get some treatments soon after birth. These include eye drops or an eye ointment to prevent an eye infection, and a dose of vitamin K to prevent abnormal bleeding.
Before your baby leaves the hospital, he or she will also have:
- A detailed physical exam
- A blood test (done by a heel prick) to check for different serious diseases that babies can be born with. For more information on this testing, ask your doctor or nurse.
- A hearing test
- A dose of the hepatitis B vaccine – Vaccines can prevent certain serious or deadly infections. Hepatitis B is a serious liver infection and other immunizations.
When should I call the doctor or nurse after a vaginal delivery?
After you leave the hospital, call the doctor if you:
- Bleed a lot from your vagina – It is normal to have some vaginal bleeding for a few weeks after delivery. But let your doctor or nurse know if you are having large blood clots or your bleeding increases.
- Feel dizzy or faint
- Get a fever
- Vomit
- Have new belly pain
- Have a severe headache or problems with your vision
- Feel sad or helpless
C-section (caesarean delivery)
What is a C-section?
A C-section is a type of surgery used for having a baby .If you have a C-section, you will be given anaesthesia so that you won’t feel pain. Then the doctor will make an incision in your belly and remove the baby from your uterus.
Will I know in advance if I need a C-section?
The most common reasons women have a caesarean delivery before they go into labour are:
- The mother had a baby by caesarean in the past
- The baby is not coming out head first
- The baby is very large
- The mother has an infection, such as herpes or HIV. These can spread to the baby during a vaginal birth.
- The mother has a condition called “placenta praevia.” In placenta previa, this organ blocks the way to the vagina.
- The baby has a problem, and the doctor believes labour and vaginal delivery might not be safe because of it.
Some women choose to have caesareans even if they don’t need to for medical reasons. You should talk to the doctor if you think you want to have your baby this way.
When should planned C-sections happen?
In most cases, you should wait until the 39th week of pregnancy or later. (A normal pregnancy lasts about 40 weeks.)
Why do some women end up having C-sections after labour begins?
A common reason is that labour doesn’t move along like it should. This can happen if:
- Contractions (the tightening of the uterus that happens during labour) are not strong enough to get the baby out
- The baby is too big
- The mother’s pelvis is too small
- The baby is in an odd position, like the head is sideways or chin-first
Other reasons that C-sections are done are:
- The baby’s life is in danger; for example, because its heart rate is too slow.
- The mother’s life is in danger; for example, because she is bleeding too much.
How is a C-section done?
Here are the main steps:
- First, you will get anaesthesia to keep you from feeling what happens during the surgery. There are 2 kinds of anaesthesia. With regional anesthesia, you stay awake. Under general anaesthesia, you are asleep.
- Next, the doctor will make an incision on your lower belly. There are 2 ways of making the incision:
- Most of the time, the incision goes across your belly, from 1 side to the other, an inch or 2 above your pubic hair.
- If you are bleeding a lot or your baby is in danger, the incision might go up and down. This kind of incision is sometimes the fastest way to get the baby out.
- After opening your belly, the doctor will make an opening in your uterus and remove the baby. Then the doctor will cut the umbilical cord and take out the placenta.
- Finally, the doctor will close your uterus and belly with stitches.
How long does it take to get better after the surgery?
Within a few hours, you will be able to move around, and eat and drink. Most women go home after 3 days, but will have some pain. It can take up to 6 weeks to heal completely. Women who have a job can usually go back to work after this time.
Are there risks of having a C-section?
Yes. Although most mothers and babies do well after a C-section, there are risks.
Compared with a vaginal delivery, C-sections are more likely to cause:
- Harm to the bladder, blood vessels, intestines, and other nearby organs
- Infection
- Blood clots that can block blood vessels and cause trouble breathing
- Lost bonding time between mother and baby
- A longer time for the mother to heal after the birth
- Problems with the placenta and uterus in later pregnancies
- Trouble breathing for the newborn. This usually lasts for just a short time.
Your doctor can help you decide if the risks of surgery are worth taking for you.
What symptoms will I have while I’m getting better?
For the first few weeks, it is common to have:
- Mild cramps in your belly
- Light bleeding and yellowish fluids coming out of your vagina
- Pain where the incision was made
Call your doctor if:
- You have a fever higher than 38°C
- Your pain gets worse
- Your vaginal bleeding gets heavier
- The incision in your belly gets more sore or red, or is bleeding or leaking fluid
Post natal care
The postnatal period can be defined as the first 6-8 weeks after birth. Postnatal care should be a continuation of the care the woman has received through her pregnancy, labour and birth and take into account the woman’s individual needs and preferences. It will aim to create a supportive environment in which families will be guided on how to care for their baby and themselves and be able to recognise and act upon any deviation from the normal.
Specific medical conditions and possible complications will be assessed and on-going medical and contraceptive needs will be addressed.
The L'Jab
The L’Jab is a 20 minute, non-surgical procedure. It begins with a simple blood draw. Then, using proprietary techniques, platelet rich plasma is extracted from the blood and injected into the numbed area near the clitoris and upper vagina to enhance sexual pleasure.
Up to 25% of women have an orgasmic dysfunction, and there are few products on the market that are designed to help. The L’Jab, is a non-surgical procedure that can stimulate the vagina in a way that positively impacts orgasms.
Because the platelet rich plasma (P.R.P) contains growth hormone factors, it rejuvenates the vagina treating also urinary stress/urge incontinence, looseness, dryness or lack of sensitivity.
There is no recovery time and results are almost immediate in some women. The effect of Genital P.R.P heightens about 3 weeks after the injection and the full effect ramps up by the third month. The effect of the injection lasts for about 8-12 months.
Almost anyone can get The L’Jab but Dr Leneque Lindeque will help you determine if this is the best procedure for you. Women both on and off hormone replacement therapy can usually benefit from this procedure.
Labiaplasty
Inner Lips (Labia Minora)
This Labiaplasty procedure is designed to alter the shape and size of the labia minora, or inner lips of the vagina with surgery. This procedure is indicated for women with asymmetrical or larger lips or those concerned about dark skin tones and unsightly genitalia. This can also be a concern for women who have a lack of self-confidence due to the appearance of their inner lips which could then affect sexual performance and enjoyment.
Outer Lips (Labia Majora)
This Labiaplasty procedure focuses on altering the shape and size of the labia majora (exterior vaginal lips) by removing the excess fat and tightening or lifting relaxed skin present there.
Almost anyone can get Labiaplasty but Dr Leneque Lindeque will help you determine if this is the best procedure for you.
Vaginoplasty
Vaginoplasty is a general term for any procedure that reshapes the vagina. These include cosmetic and therapeutic operations of both the opening, known as the introitus, and the canal of the vagina. This procedure is usually necessary in women whose vagina’s have been damaged or changed shape after childbirth or with aging.
The Vaginoplasty procedure involves bringing the pelvic floor muscles closer together, removal of any loose skin or scar tissue or a combination of these procedures. The end result is a neater and reconstructed vagina that will improve the functionality and pleasure during sexual relations.
Almost anyone can get a Vaginoplasty but Dr Leneque Lindeque will help you determine if this is the best procedure for you.
Vaginal Laser Rejuvenation
Your vaginal laser rejuvenation at FemRegenX takes less than 30 minutes. Life processes such as childbirth, weight fluctuations and hormonal changes may overstretch and damage vaginal tissue, damage the pelvic floor and alter the mucosal tone of the vaginal wall.
Vaginal laser rejuvenation is virtually painless and has no side effects. A single-use probe is inserted into the vagina in the consulting rooms and is rotated as the laser is applied to the vaginal tissue.
A state-of-the-art, minimally-invasive outpatient solution that incorporates CO2 technology to provide optimal care for various feminine concerns. The procedure is fast, painless and completely safe, and provides highly effective results. Procedures are conducted in an outpatient setting, and do not require anaesthesia or downtime, ensuring that women can resume their routine – and regain their confidence – soon after.
Dr Lindeque offers a versatile and wide range of solution that enable her to treat feminine indications and boost women’s wellness quickly and effectively.
Almost anyone can get vaginal laser rejuvenation but Dr Leneque Lindeque will help you determine if this is the best procedure for you.
Intimate Area Bleaching
Intimate Area Bleaching, will correct Vulvar hyper pigmentation or darkening of the skin caused by an increased concentration of melanin, which can occur in response to certain medical conditions, medications, and physical irritation. It can affect self-confidence and also sexual health.
While it could be seen as a superficial, perhaps unnecessary procedure, darkened skin can have a hugely negative impact on women’s confidence. “Genital bleaching allows women to regain confidence they may have lost due to darkening genital skin.
Treatments include the application of various chemicals that lighten and soften the affected area, lightening peels to resurface the skin, and the latest generation fractional CO2 laser or a combination of the above.
The Intimate Area Bleaching procedure takes place over three or more sessions (depending on the severity) of laser therapy lasting 10 to 15 minutes per session. This procedure is done in the consulting rooms and is performed using local anaesthetics. The laser therapy can then be augmented by chemical treatments and home-use application creams.
Almost anyone can get a Intimate Area Bleaching but Dr Leneque Lindeque will help you determine if this is the best procedure for you.
Our
Doctor
What makes me tick?
“I am an artist at heart & enjoy all art forms with a great appreciation & some participation, particularly oil painting & craft. Since the birth of our beautiful son, Nico, I am even more family-centered & treasure the times together with them. I am thankful to be equipped to help my fellow woman & strive each day to give my best & achieve excellence.”
Things I’ve done
Home Sweet Home
In 2008 I returned to the Cape & spent
the next four years working & learning
in Tygerberg Academic Hospital & qualified
as a specialist in December 2011
Exchange program
I spent 3 months on a exchange program
in Amsterdam ♥ where I worked in their first
world setting at Onze Liewe Vroue Gastehuis
Always the scholar
Two years were spent securing my knowledge
& expertise in the academic environment
where I enjoyed lecturing both under-graduate
& post-graduate students & working with some
of the country’s most renowned professors in the field
Things
to
be
proud
of !
Leneque X Lindeque inc. founder, specialist obstetrician & gynaecologist. FemRegenX co-founder and accredited senior member of the European Society of Aesthetic Gynaecology.
I was born in Johannesburg on the 17th of January. At the age of ten my family relocated to Natal where I finished school in Durban at Danville Park Girls’ High School.
Tertiary
I was privileged enough to have the opportunity
to study medicine at Stellenbosch University
Internship
I served at McCord Hospital in Durban
and spent a year serving my community
service at Mseleni Hospital in Northern Natal
Experience
I travelled to the Northern Island of New Zealand
& worked as a medical officer in Northland District
Hospital, Whangarei. Not a month after my arrival
abroad I realised I wanted to specialise in the discipline
that had always come naturally to me, & that at my Alma Mater
Our
Doctor
What makes me tick?
“I am an artist at heart & enjoy all art forms with a great appreciation & some participation, particularly oil painting & craft. Since the birth of our beautiful son, Nico, I am even more family-centered & treasure the times together with them. I am thankful to be equipped to help my fellow woman & strive each day to give my best & achieve excellence.”
Things I’ve done
Home Sweet Home
In 2008 I returned to the Cape & spent
the next four years working & learning
in Tygerberg Academic Hospital & qualified
as a specialist in December 2011
Exchange program
I spent 3 months on a exchange program
in Amsterdam ♥ where I worked in their first
world setting at Onze Liewe Vroue Gastehuis
Always the scholar
Two years were spent securing my knowledge
& expertise in the academic environment
where I enjoyed lecturing both under-graduate
& post-graduate students & working with some
of the country’s most renowned professors in the field
Things
to
be
proud
of !
Leneque X Lindeque inc. founder, specialist obstetrician & gynaecologist. FemRegenX co-founder and accredited senior member of the European Society of Aesthetic Gynaecology.
I was born in Johannesburg on the 17th of January. At the age of ten my family relocated to Natal where I finished school in Durban at Danville Park Girls’ High School.
Tertiary
I was privileged enough to have the opportunity
to study medicine at Stellenbosch University
Internship
I served at McCord Hospital in Durban
and spent a year serving my community
service at Mseleni Hospital in Northern Natal
Experience
I travelled to the Northern Island of New Zealand
& worked as a medical officer in Northland District
Hospital, Whangarei. Not a month after my arrival
abroad I realised I wanted to specialise in the discipline
that had always come naturally to me, & that at my Alma Mater
Our Team
“We believe that every woman deserves to enjoy her feminine wellness to its fullest and to live in harmony with her body and self, always.”
Our Team
“We believe that every woman deserves to enjoy her feminine wellness to its fullest and to live in harmony with her body and self, always.”
Our Practice
A state-of-the-art, soothing environment designed with one purpose in mind, to provide optimal care for various feminine concerns. Procedure rooms and spaces, that provide the doctor areas to produce highly effective results.
Procedures are conducted in an outpatient setting, and do not require anaesthesia or downtime, ensuring that women can resume their routine – and regain their confidence – soon after.
Dr Lindeque offers a versatile and wide range of solutions, that enable her to treat feminine indications and boost women’s wellness quickly and effectively.
Our Practice
A state-of-the-art, soothing environment designed with one purpose in mind, to provide optimal care for various feminine concerns. Procedure rooms and spaces, that provide the doctor areas to produce highly effective results.
Procedures are conducted in an outpatient setting, and do not require anaesthesia or downtime, ensuring that women can resume their routine – and regain their confidence – soon after.
Dr Lindeque offers a versatile and wide range of solutions, that enable her to treat feminine indications and boost women’s wellness quickly and effectively.
Our
Articles
How the HPV vaccine can help reduce your child’s risk of cancer
The human papilloma virus (HPV) is the most common sexually transmitted disease (STD) and is spread through sexual intercourse, as well as genital skin-to-skin contact. Thankfully most
Aesthetic Gynecology by Dr Lindeque
Aesthetic Gynecology - Dr Leneque Lindeque puts South Africa on the mapDr Leneque Lindeque is a specialist Obstetrician and Gynaecologists based in Ballito, servicing clientele
Pelvic inflammatory disease – Q&A
Dr Leneque Lindeque of Ballito will soon be offering laser treatment for Stress urinary incontinence, vaginal dryness and vaginal tightening along with treatments for bleaching, tightening and cosmetic labioplasty. Contact here practice today on 032 586 0723 or email reception@femregenx.co.za for more information.