Gynae Care With Dr Pragya

Gynae Care With Dr Pragya Empowering Women Health
Expert in PCOS, Period Problems, Infertility & CosGyn

30/03/2026

“Ma’am, my ultrasound says I have PCOS… is it true?”

This is one of the most common concerns I hear from young girls.

Let me clarify an important concept. An ultrasound may show PCOM (Polycystic Ovarian Morphology), which means the ovaries appear slightly bulky with multiple small follicles. This is not the same as PCOS.

In the first few years after the onset of periods, such findings can be completely normal, as the body is still adjusting hormonally. So seeing “cysts” on an ultrasound at a young age does not confirm a disease.

PCOS cannot be diagnosed by ultrasound alone.
We look at a combination of:
• Clinical symptoms like acne, excessive facial/body hair (hirsutism), sleep issues, mood changes
• Blood tests showing hormonal imbalance (testosterone, DHEA-S, insulin levels, LH/FSH ratio, HbA1c, AMH)
• Ultrasound findings

We follow Rotterdam criteria, where at least 2 out of these 3 need to be present to diagnose PCOS.
It is also important to understand that:
• You can have irregular periods and still not have PCOS
• You can have PCOS even with regular periods

In this case, the reports were normal and there were no clinical symptoms. So there is no need to label it as PCOS based only on ultrasound.
Don’t panic after reading your report.
Get the right evaluation, understand your body, and avoid unnecessary stress.

Infertility is often seen as a “woman’s problem”, but that is far from the truth.In a significant number of cases, male ...
27/03/2026

Infertility is often seen as a “woman’s problem”, but that is far from the truth.
In a significant number of cases, male factors play an equal role , yet they are the most ignored.

Low s***m count, poor motility, erectile dysfunction, ej*******on issues, lifestyle habits like smoking and alcohol, obesity, stress, even conditions like diabetes or varicocele can directly impact male fertility. The challenge is that many of these do not show obvious symptoms and go unchecked.

If you are trying to conceive and not seeing results, it is important that both partners get evaluated together. A simple semen analysis, along with basic medical assessment, can provide crucial answers and prevent unnecessary treatments for the woman.

Fertility is a shared journey. It is not about blame, it is about awareness, timely diagnosis and the right support.

The sooner you look at the complete picture, the better your chances of a healthy pregnancy.

***mcount

24/03/2026

She came to me after multiple treatments and cycles, exhausted and still unable to conceive. We worked on her hormonal issues and gradually everything started coming back to normal. Yet, pregnancy did not happen.

I asked her to bring her husband for evaluation and counselling. She broke down. Her husband, who is diabetic, smokes and consumes alcohol, refused to come. He and his family believed the problem could not be from his side.

This is a reality many women silently face.
Infertility is not just a woman’s issue. Conception requires both healthy eggs and healthy s***m. Male factors contribute to a significant number of infertility cases, yet are often ignored due to stigma and lack of awareness.

Stress, emotional pressure and lack of support can also disturb hormonal balance in women, making the journey even more difficult.
If you are trying to conceive, both partners must be evaluated together. A simple semen analysis, lifestyle changes and timely intervention can make a big difference.

Let us move away from blame and move towards understanding.

Because a baby is created by two, and so should be the responsibility.


19/03/2026

Many women ask me, “Doc, my AMH is normal, then why am I still not able to conceive?”
Let’s understand this clearly.

AMH (Anti-Müllerian Hormone) tells us about the quantity of eggs, not their quality. To assess ovarian reserve better, we also do a transva**nal ultrasound on Day 2 or 3 of the period to check the Antral Follicular Count (AFC). This helps us estimate how many eggs are available and how many may potentially contribute to a successful pregnancy.

But here’s the key point:
Egg quality primarily depends on age.
After the age of 35, both the quantity and quality of eggs start declining more rapidly. In today’s lifestyle, factors like stress, poor diet and environmental exposures increase oxidative stress, which can lead to mitochondrial dysfunction, DNA fragmentation and chromosomal abnormalities (aneuploidy). This also increases the risk of miscarriages.

The good news?

A healthy lifestyle can help support better egg quality, even as age advances.

So don’t rely on AMH alone. Understand your fertility window, get the right evaluations at the right time and make informed choices.
Your fertility is not just about numbers, it’s about timing, biology and lifestyle working together.

Many of the products we use every day may be quietly interfering with our hormones.These chemicals are called endocrine ...
16/03/2026

Many of the products we use every day may be quietly interfering with our hormones.
These chemicals are called endocrine disruptors. They can mimic or block natural hormones in the body and disturb the delicate hormonal balance that regulates menstruation, fertility, metabolism and even pregnancy.

They are commonly found in everyday items such as plastic containers, food packaging, cosmetics, perfumes, non-stick cookware, cleaning sprays and even pesticide residues on fruits and vegetables. Long term exposure has been linked in scientific studies to hormonal imbalance, thyroid issues, PCOS, fertility challenges and developmental concerns during pregnancy.

The reality is that it is almost impossible to eliminate them completely from modern life. But we can certainly reduce our exposure with simple lifestyle choices. Avoid heating food in plastic containers, prefer glass or steel storage, limit packaged foods, wash fruits and vegetables well and choose safer personal care products whenever possible.

Small everyday decisions can make a meaningful difference to your hormonal and reproductive health.

Awareness is the first step toward protection.

11/03/2026

One of my patients recently came to me very worried. Multiple ultrasound reports had mentioned a “cyst” in the o***y. In some reports it was written as 1 cm, while in others it was as small as 6 mm. Naturally, she had already been prescribed several medicines and was quite anxious.

When I reviewed the reports, I noticed an important detail. All the ultrasounds had been done around the mid-cycle period.

Around the middle of the menstrual cycle, the o***y normally develops a dominant follicle. This follicle contains the egg that will be released during ovulation. On an ultrasound, this normal follicle can sometimes be mistaken for a small cyst, especially if the timing of the scan is not considered.

In many such cases, what appears to be a “cyst” is actually a normal part of the ovulation process.

This is why proper interpretation of reports and correct timing of ultrasound is important. If there is a concern regarding ovarian cysts, it is best to consult a qualified gynecologist and, when required, undergo a transva**nal ultrasound, which provides a clearer and more accurate view of the reproductive organs.

Not every finding on a report is a disease. Sometimes, it is simply normal physiology.

06/03/2026

A 45-year-old patient recently came to me with adenomyosis and abnormal uterine bleeding. She was also dealing with high blood pressure and was very clear that she did not want to undergo surgery. She asked me if there was a safe, non-surgical way to manage her symptoms.

After evaluating her condition, I suggested Mirena, an intrauterine hormonal device that can help manage such cases effectively.

Mirena is a small T-shaped device that is placed inside the uterus. It slowly releases a hormone called levonorgestrel, which acts locally on the uterine lining. This helps thin the lining of the uterus and reduce excessive menstrual bleeding, which is often the main concern in conditions like adenomyosis.

In my practice, hormonal intrauterine devices like Mirena can be helpful for women dealing with conditions such as:

- Adenomyosis with heavy bleeding
- Abnormal uterine bleeding
- Very heavy or prolonged menstrual periods
- Painful periods
- Thickened uterine lining (endometrial hyperplasia)

Because the hormone works primarily within the uterus, it can significantly reduce bleeding and improve quality of life for many women who are looking for an effective alternative to surgery.

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Contact Dr. Pragya at 9415240772.

**nalhealth

Holi reminds us that life is made of many colors. And so is a woman’s journey.From the red of her first period to the go...
03/03/2026

Holi reminds us that life is made of many colors. And so is a woman’s journey.

From the red of her first period to the golden hope of motherhood, from silent hormonal struggles to powerful resilience, every phase carries its own shade and its own story.

Behind the smiles and celebrations, many women are navigating PCOS, irregular cycles, infertility journeys, pregnancy anxieties or emotional ups and downs. This festive season, let us choose awareness along with celebration.

Add one more color to your life this Holi - SELF CARE. Book that check up. Listen to your body. Prioritize your mental and reproductive health. Support the women around you.

When a woman feels healthy and heard, her world shines brighter.

Wishing you a safe, joyful and vibrant Holi.

02/03/2026

On my previous reel about pregnancy at a later age, some of you commented, “But I know someone who conceived naturally at 38 or 40 without any problem. Then why create fear?”

Let me clarify with science, not fear.
Yes, it takes just one healthy egg to make a baby. And yes, many women do conceive naturally in their late 30s or even 40s. But medically, we do not counsel based on exceptions. We counsel based on biology and probability.

A woman is born with a fixed number of eggs. As age increases, not only does the number of eggs decline, but the quality of eggs also reduces. With advancing age, we see higher chances of:
• DNA damage within the egg
• Mitochondrial dysfunction, which affects energy supply to the developing embryo
• Chromosomal abnormalities
• Increased risk of miscarriage

This does not mean pregnancy is impossible. It means the risks are statistically higher, and therefore monitoring needs to be more careful.

Medicine is about awareness and preparation, not panic. If we identify risks early, we can plan better, screen appropriately and support both mother and baby safely.

Every woman’s journey is unique. My role is to explain the science so you can make informed decisions, not to discourage, but to empower.

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Contact Dr. Pragya at 9415240772.

26/02/2026

Not every white discharge is a problem. Sometimes it’s just your body doing its job.

In this counselling session, an 18-year-old patient was worried about persistent white discharge and weakness after taking multiple antibiotics without relief. But the important question is: is it actually an infection?

Normal va**nal discharge changes through the menstrual cycle. Around ovulation it can become thicker, and closer to periods it may turn more watery. If there is no foul smell, no itching, no pain, no fever and no urinary complaints, this is usually physiological discharge caused by hormonal changes, not an infection.

Our va**na naturally contains protective bacteria called Doderlein flora that maintain an acidic pH and prevent infections. Overuse of antibiotics, intimate washes, home remedies like curd or oils can disturb this balance, causing more harm than good. Routine use of products like va**nal washes can dry the area and reduce good bacteria.

Feeling weak at this age is often related to nutritional gaps after the onset of periods, not discharge itself. The focus should be on a balanced diet, iron intake, hydration and avoiding unnecessary medications.

Understanding what is normal is the first step toward better intimate health. Sometimes reassurance is the best treatment.

____

Contact Dr. Pragya at 9415240772.

**nalhealth

23/02/2026

What you eat, feel and experience during pregnancy doesn’t just affect you, it can influence how your baby’s genes behave. This science is called epigenetics.

Epigenetics means changes in gene expression without changing the DNA sequence itself. In simple words, your baby receives genes from both parents, but the environment inside the womb decides which genes get “switched on” or “switched off”.

Research shows that maternal lifestyle plays a powerful role in this process. Smoking can alter placental blood flow and cause epigenetic changes linked to low birth weight and future metabolic disorders. A diet high in processed or fast foods may influence genes related to obesity, insulin resistance and inflammation. Chronic stress increases cortisol levels, which can affect fetal brain development and stress-response pathways through epigenetic mechanisms.
On the other hand, balanced nutrition, adequate sleep, physical activity and emotional wellbeing support healthy gene expression.

Nutrients like folate, iron, omega-3 fatty acids and antioxidants are especially important because they participate in DNA methylation - one of the key epigenetic processes shaping fetal development.

This is why pregnancy care is not only about scans and medicines. It is about daily choices, what you eat, how you manage stress, the air you breathe and the habits you build.

You are not just growing a baby, you are shaping lifelong health patterns. Small conscious choices today can influence your child’s future in ways science is only beginning to fully understand.

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Contact Dr. Pragya at 9415240772.

20/02/2026

In my reel on Pap smear some people commented that Pap smear is a basic test and there are advanced tests available now. Let me talk about one of them. This one is called LBC - Liquid Based Cytology.

In a conventional Pap smear, the collected cervical cells are directly spread on a glass slide, which sometimes leads to unclear samples due to blood, mucus or inflammation. In LBC, the cells are collected using a special soft collection brush with fine flexible bristles that gently rotate over the cervix to pick up cells evenly. The brush head is then rinsed into a vial containing preservative liquid, ensuring almost all collected cells are retained and processed in the lab.

Because the sample is filtered and cleaned before examination, LBC provides clearer slides, fewer inadequate reports and better detection of early precancerous changes. Another major advantage is that the same preserved sample can also be used for HPV testing without repeating the procedure.

HPV (Human Papillomavirus) is very common and certain high-risk strains are responsible for most cervical cancer cases. When we combine LBC with HPV testing, we can identify risk much earlier, often years before disease develops, allowing timely monitoring and treatment.

The test is simple, quick and usually painless. It is especially recommended for women above 30, those with irregular screening history or anyone wanting more accurate preventive screening.

Cervical cancer is one of the most preventable cancers, but only if screening is done on time. Ask your doctor whether LBC with HPV testing is right for you. Prevention starts with awareness.

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Contact Dr. Pragya at 9415240772.

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Prithivipuram, Sultanpur Road, Ahmamau
Lucknow
226002

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+917376987574

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