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Endometriosis is a common gynaecological condition affecting women of childbearing age. The name of this condition comes from the word "endometrium," which is the tissue that lines the uterus. During a woman's regular menstrual cycle, this tissue builds up and is shed if she does not become pregnant. Women with endometriosis develop tissue that looks and acts like endometrial tissue outside of the uterus, usually on other reproductive organs inside the pelvis or in the abdominal cavity. Each month, this misplaced tissue responds to the hormonal changes of the menstrual cycle by building up and breaking down just as the endometrium does, resulting in small bleeding inside of the pelvis. This leads to inflammation, swelling and scarring of the normal tissue surrounding the endometriosis implants.

Symptoms of endometriosis may include excessive menstrual cramps, abnormal or heavy menstrual flow and pain during intercourse. Laparoscopy, a minimally invasive surgical procedure, can be used to definitively diagnose and treat endometriosis.

Dyspareunia is a persistent or recurrent pain that can happen during sexual intercourse. Causes vary widely and it can lead to distress and relationship problems. Painful intercourse can affect both men and women, but it is more common in women. A variety of factors – physical to psychological – can contribute. Treatment normally focuses on the underlying cause. The defining symptom of dyspareunia is pain with intercourse that may occur at the vaginal opening or deep in the pelvis. The pain may be distinct and localized, or there may be a broader sense of discomfort. There be an aching, burning, throbbing, or ripping sensation.

Uterine fibroids affect about 20-25% of all women and are increasingly more common in women over the age of 30. Fibroids are a benign tumour in the lining, the wall, or the endometrial layer of the uterus. Uterine fibroids are often left alone if the tumours are small and out of the way, but will require treatment if they are growing rapidly, impacting fertility, or causing pain or heavy bleeding.

A pregnancy is considered high-risk when there are potential complications that could affect the mother, the baby or both. High-risk pregnancies require management by a specialist to help ensure the best outcome for the mother and baby.

Maternal Age -one of the most common risk factors for a high-risk pregnancy is the age of the mother-to-be. Women who will be under age 17 or over the age of 40.

Medical conditions that exist before pregnancy - conditions such as high blood pressure, lung, kidney, or heart problems, diabetes, autoimmune disease, sexually transmitted diseases (STDs); or chronic infections such as human immunodeficiency virus (HIV) can present risks for the mother and/or her unborn baby. A history of miscarriage, problems with a previous pregnancy or pregnancies, or a family history of genetic disorders, are also risk factors for a high-risk pregnancy.

Healthcare providers consider a couple infertile if they try but fail to get pregnant within one year. Having troubles conceiving can be caused by problems with ovulation, blocked fallopian tubes, endometriosis, PCOS, premature menopause, fibroids, thyroid problems, and sperm problems. Depending on the cause there are several treatment options that can be considered, to determine what is appropriate in your own case,

When you are struggling with fertility issues, you might experience different emotions, all at the same time. But there is one feeling you may need more of - hope. Seeking medical help for fertility issues can provide you with a sense of hope. Schedule an appointment with Dr. Afraz Ali who will take you through this process.

Urinary incontinence and pelvic organ prolapse commonly co-exist. Up to 60% of women presenting with pelvic organ prolapse are also diagnosed with urinary incontinence, and close to 40% of women presenting with urinary incontinence, in turn, are found to have some degree of pelvic organ prolapse. The first symptom that women with a prolapsed bladder usually notice is the presence of tissue in the vagina that many women describe as something that feels like a ball.

Other symptoms of a prolapsed bladder include the following:

  • Discomfort or pain in the pelvis
  • Tissue protruding from the vagina (The tissue may be tender and may bleed)
  • Difficulty urinating
  • A feeling that the bladder is not empty immediately after urinating (incomplete voiding)
  • Stress incontinence (urine leakage during sneezing, coughing, or exertion)
  • More frequent bladder infections
  • Painful intercourse (dyspareunia)
  • Low back pain

Hirsutism is dark hair appearing on the body where women do not commonly have hair — primarily the face, chest, lower abdomen, inner thighs and back.

Hirsutism may be caused by:

  • Polycystic ovary syndrome (PCOS). This condition, which often begins with puberty, causes an imbalance of sex hormones. Over years, PCOS may slowly result in excess hair growth, irregular periods, obesity, infertility, and sometimes multiple cysts on the ovaries.
  • Cushing syndrome. This occurs when your body is exposed to high levels of the hormone cortisol. It can develop from your adrenal glands making too much cortisol or from taking medications such as prednisone over a long period.
  • Congenital adrenal hyperplasia. This inherited condition is characterized by abnormal production of steroid hormones, including cortisol and androgen, by your adrenal glands.


Hirsutism can be emotionally distressing. Some women feel self-conscious about having unwanted hair. Some develop depression. Although hirsutism doesn't cause physical complications, the underlying cause of a hormonal imbalance can.

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