Dr. Shehla Jamal, a Professor and Unit Head at RMRI Bareilly, is making waves in the field of women’s health. With a pragmatic approach and a wealth of experience, Dr. Jamal leads by example in both academia and clinical practice.
As President of the Society of Menstrual Disorders and Hygiene Management, Dr. Jamal is at the forefront of initiatives aimed at improving menstrual health awareness and accessibility. In an exclusive interview with Health on Air (HoA) on the occasion of Women’s Day, Dr. Jamal provides invaluable insights into maintaining optimal menstrual and vaginal health. From dos and don’ts to navigating cosmetic gynaecology, PCOS, menopause, and infertility, her expertise shines through as she shares essential guidance for women everywhere.
Excerpts from the interview
HoA: Could you explain what constitutes a menstrual disorder and when a normal menstrual process might veer into disorder territory?
Dr. Shehla: Thank you for having me, and Happy Women’s Day to everyone. Understanding menstrual disorders requires a grasp of menstrual health’s four components: the menstrual cycle, psychosocial aspects, wash component (water, sanitation, hygiene), and accessibility. It’s crucial to first establish what is considered normal. Menstruation typically occurs monthly, lasting around seven days. Anything deviating significantly from this norm, such as bleeding for more than seven days or having cycles shorter than 21 days, might indicate a disorder. Heavy menstrual bleeding, defined as bleeding over 80 ml per cycle or causing significant disruption to daily life, is another common disorder. Tracking these parameters helps identify potential issues.
HoA: The mathematics behind menstruation cycles is intriguing. How do we know when to seek advice from a healthcare provider regarding our menstrual health?
Dr. Shehla: Pain during menstruation, or dysmenorrhea, can vary in intensity. Using a visual analog scale to quantify pain, a score of five or less indicates manageable discomfort, while anything higher might warrant medical attention. Engaging in activities like yoga or mild exercises can help alleviate mild pain. However, severe pain, especially scoring higher than five or six on the scale, might signify underlying conditions like endometriosis or pelvic inflammatory disease, requiring consultation with a gynaecologist. It’s important not to self-medicate, as each person’s body reacts differently to medications.
HoA: Could you describe extreme menstrual disorders and how they impact individuals?
Dr. Shehla: Extreme menstrual disorders encompass conditions like heavy menstrual bleeding, often associated with adenomyosis or fibroids, leading to significant blood loss, anemia, and clotting issues. Conversely, conditions like amenorrhea, or the absence of menstruation, can stem from factors like PCOS. Dysmenorrhea, especially in cases of endometriosis, can cause severe pain, significantly affecting quality of life.
HoA: How are these conditions managed, particularly with the prevalence of PCOS?
Dr. Shehla: PCOS diagnosis follows specific criteria, including irregular menstruation, hyperandrogenism features, and ovarian cysts detected through ultrasound. Lifestyle modifications play a crucial role in managing PCOS, including dietary changes and maintaining a regular sleep schedule. Beyond age 26, decisions regarding the HPV vaccine become subjective, with potential benefits varying. For those under 26, the vaccine remains beneficial in protecting against cervical cancer.
HoA: What about maintaining vaginal health? Are there specific practices individuals should follow?
Dr. Shehla: The vagina is self-cleaning, requiring minimal intervention for maintenance. However, it’s essential to change menstrual hygiene products every 4-6 hours to prevent bacterial growth. Practices like daily bathing and washing the vulvovaginal area from front to back help maintain hygiene. Avoiding unnecessary products like vaginal washes is advisable, as they can disrupt the natural flora and increase the risk of infections.
HoA: Addressing myths about reproductive health is crucial. What common misconceptions have you encountered in your practice?
Dr. Shehla: One prevalent myth is the belief that exercise during menstruation is harmful, which isn’t true. Another misconception is the association between hair or eye washing and fertility, which has no significant impact. Additionally, trends like using menstrual blood for facials are not advisable, as menstrual blood is a waste product meant to be expelled. Lastly, there’s a misconception that certain foods like papaya can affect fertility directly, which isn’t supported by evidence.
HoA: Can thyroid issues affect menstrual regularity and flow?
Dr. Shehla: Absolutely. Hypothyroidism can disrupt ovulation, leading to irregular menstrual cycles. If experiencing irregular periods alongside thyroid issues, it’s essential to consult a healthcare provider for proper management.
