Ask the Expert: What do period changes indicate
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I am noticing changes in my menstrual cycle length and flow. Are these early signs of perimenopause, and how do they affect fertility?
— Suman Sharma (42), Nahan
Yes, any changes in menstrual cycle or missed periods in early 40s can be signs of perimenopause. Hormonal fluctuations during this time can cause irregular ovulation, heavier or lighter bleeding and premenstrual changes. Fertility naturally declines in the early 40s due to reduced egg quantity and quality, and irregular cycles may lower conception chances. If you wish to plan pregnancy, best to consult a gynaecologist and get your fertility evaluated.
— Dr Kanchi Khurana, Gynaecologist, Cloudnine Hospital, Chandigarh
I have Type 2 diabetes since last 5 years. I take my medicine regularly. My HbAIc level remain between 6 and 7, and thyroid, Vit D, B-12 levels are also okay. Though I am physically active, I don't feel like walking. My sleep is also affected as I get up 2-3 times to use the washroom.
— Vijay Laxmi (78), Shimla
You have good sugar control. At this age, increased night-time urination in women is often because of bladder-related issues or age-associated bladder function changes. These can disturb sleep significantly. Poor-quality sleep can lead to fatigue, reduced stamina and decreased interest in routine physical activity. Please get a clinical evaluation done to assess bladder function. Meanwhile, limit fluid intake 2–3 hours before bedtime.
Dr Akansha Gautam, Endocrinologist, Livasa
Hospital, Mohali
My mother (75) had normal kidneys before a heart attack and angioplasty in October last years. After treatment (Vymada, Brilinta, digoxin) and torsemide since December for breathlessness, her eGFR fell to 20. She has mild MR. How can we protect her kidneys? Could medications contribute?
— Dr Arshi Pal Kaur, Fazilka
A fall in eGFR after a cardiac event can sometimes occur due to medications, dehydration, or reduced kidney perfusion (reduced blood flow to the kidneys causing oxygen starvation and potentially acute kidney injury) after heart disease. Certain drugs used after angioplasty and for heart failure may affect kidney function in some patients. Since your mother’s eGFR has dropped significantly, please consult a nephrologist. Her medications should be carefully reviewed and adjusted in coordination with her cardiologist to protect kidney function while maintaining heart health.
Dr Raka Kaushal, Nephrologist, Livasa
Hospitals, Mohali
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