Many women in Ahmedabad see a gynecologist only during pregnancy, and quietly put up with everything else: irregular or painful periods, white discharge, itching, pelvic pain, or worries about contraception and cervical cancer. Most of these problems are common, quick to assess and very treatable, and a timely visit often prevents a small issue from becoming a larger one.
A gynecology consultation is also a chance for preventive care: a Pap smear or HPV test, advice on the HPV vaccine for daughters, a check for anaemia and thyroid problems, and planning before a pregnancy. For teenage girls, a first visit is usually just a conversation about periods, with no internal examination.
Dr. Devang Patel, M.D. (Obstetrics & Gynecology, Gold Medalist), has handled more than 75,000 OPD consultations and sees women of all ages at Divine Women’s Hospital, Gota. Consultations are private and unhurried, and can be held in Gujarati, Hindi or English.
What a gynecology visit involves
The visit begins with a conversation: your periods, symptoms, past pregnancies, contraception, medical conditions and family history. Bringing previous reports, scans and a note of your last few period dates saves time and makes the advice more precise.
An examination is done only if it is needed and only with your agreement. It may include a check of the abdomen, a speculum examination to see the cervix, and an internal examination. Unmarried women and adolescents are usually assessed with an abdominal ultrasound rather than an internal one. You are welcome to have a family member present, or to ask for a female chaperone.
Many problems are sorted out at the first visit. Others need a pelvic ultrasound or blood tests, with a review once the results are back.
Periods: what is normal and what is worth checking
Every woman’s cycle is a little different, but there are useful limits. The table below follows the FIGO definitions used by gynecologists worldwide.
| Feature | Usually normal | Worth getting checked |
|---|---|---|
| Cycle length | 21–35 days from the start of one period to the next | Shorter than 21 days, longer than 35 days, or no period for 3 months |
| Duration of bleeding | Up to 7–8 days | Bleeding longer than 8 days |
| Amount of flow | Manageable with regular pads or a cup | Changing a pad every 1–2 hours, clots larger than a ₹5 coin, flooding at night |
| Regularity | Varies by a few days from month to month | Varies by more than 7–9 days, or is unpredictable |
| Bleeding at other times | Light spotting around ovulation in some women | Bleeding between periods, after intercourse, or after menopause |
| Pain | Cramping in the first 1–2 days, eased by simple tablets | Pain that stops work or school, or pain that is worsening year by year |
Why period problems happen
Gynecologists sort the causes of abnormal bleeding into structural problems that can be seen on a scan, and functional problems that cannot. The structural group includes polyps, fibroids, adenomyosis (the lining growing into the muscle of the uterus) and, rarely, a precancerous or cancerous change in the lining.
The functional group includes irregular ovulation, as in PCOS, thyroid disorders, a raised prolactin level, bleeding disorders, side effects of medicines and the hormonal shifts of the years before menopause. Stress, sudden weight change and heavy exercise also affect cycles.
Heavy periods are a major cause of anaemia in Indian women. Tiredness, breathlessness on climbing stairs, hair fall and pale skin should prompt a haemoglobin test, and iron deficiency should be treated alongside the bleeding.
White discharge, itching and infections
Some vaginal discharge is normal: clear or white, without a strong smell, and varying through the cycle. Discharge that changes colour, smells, causes itching or burning, or comes with pelvic pain needs a check, because the treatment depends on the cause.
- Bacterial vaginosis: thin grey-white discharge with a fishy smell, treated with a short course of antibiotics
- Candida (thrush): thick curd-like discharge with itching, more frequent in hot humid weather, with diabetes, after antibiotics and in pregnancy
- Trichomonas and other sexually transmitted infections: frothy or yellow-green discharge, sometimes with pain; partners need treatment too
- Pelvic inflammatory disease: lower abdominal pain, fever and discharge, which must be treated promptly to protect fertility
- Urinary infections: burning and frequent urination, often mistaken for a vaginal infection
Recurrent thrush is a common first clue to raised blood sugar, so a sugar test is worth doing if infections keep coming back.
Cervical cancer screening and the HPV vaccine
Cervical cancer is one of the commonest cancers in Indian women, yet it is one of the most preventable. Almost all cases are caused by long-standing infection with high-risk types of human papillomavirus (HPV), and the changes take years to develop, which gives screening plenty of time to find them.
A Pap smear looks for abnormal cells on the cervix; an HPV test looks for the virus itself. A common approach is a Pap smear every three years from age 25, and from age 30 an HPV test, alone or with a Pap smear, every five years if results are normal. The WHO recommends HPV-based screening from age 30 for most women. The test takes a couple of minutes, is done in the clinic and is ideally timed away from your period.
The HPV vaccine prevents infection with the types that cause most cervical cancers. It is most effective when given before any exposure, ideally between 9 and 14 years of age as two doses, with three doses from 15 years onwards. Women who are vaccinated still need screening, because the vaccine does not cover every high-risk type.
Care for adolescent girls
The first period usually arrives between 10 and 16 years of age, and cycles are often irregular for the first two to three years. A first gynecology visit for a teenager is mainly a conversation, often with a parent present for part of it, and an internal examination is rarely needed.
- No period by 15 years, or within three years of breast development starting
- Very heavy periods from the start, which can point to an inherited bleeding disorder
- Period pain that causes regular absence from school or college
- Irregular cycles with acne, excess hair or weight gain, suggesting PCOS
- Tiredness and poor concentration from anaemia, which affects more than half of adolescent girls in India according to national survey data
- Questions about the HPV vaccine, hygiene, and healthy eating and activity
Pelvic pain, lumps and scan findings
Pain in the lower abdomen can come from the uterus, ovaries, bowel, bladder or back. Period pain that worsens year after year, pain during intercourse and pain with bowel movements during periods suggest endometriosis or adenomyosis, both of which are under-diagnosed and can affect fertility.
Fibroids and ovarian cysts are often found by chance on an ultrasound done for another reason. Most need no surgery, but they do need to be correctly identified and, where appropriate, followed up. Detailed information is on the fibroid and ovarian cyst pages.
Health checks through the decades
- 20s: period health, HPV vaccination if missed, cervical screening from 25, contraception, and haemoglobin
- 30s: cervical screening, pre-conception check-up with folic acid before pregnancy, thyroid and sugar testing, especially with PCOS or a family history of diabetes
- 40s: heavier or irregular perimenopausal periods, blood pressure, sugar and cholesterol, breast awareness and screening advice
- 50s and beyond: menopause symptoms, bone health and vitamin D, heart health, and urgent assessment of any bleeding after menopause
- At every age: monthly breast self-awareness, a balanced diet with enough protein, iron and calcium, and regular activity
How the gynecology clinic works at Divine Women’s Hospital
OPD consultations with Dr. Devang Patel are by appointment at Divine Women’s Hospital, Athena Avenue, Gota, which keeps waiting short and allows enough time to talk. Pelvic ultrasound, Pap smears and routine blood sampling can be arranged at the same visit where needed.
If treatment needs a procedure, such as hysteroscopy for a polyp or laparoscopy for a cyst, it is done in the same NABH-accredited hospital, and urgent problems such as heavy bleeding or severe pain are seen at any hour through the 24 × 7 emergency service.
Your care, step by step
- Book a visitCall or message to book an OPD appointment, and bring old reports and a note of your recent period dates.
- ConversationYour concerns, cycle pattern, health history and goals are discussed in the language you are most comfortable with.
- Examination and testsOnly what is needed, with your consent: a pelvic ultrasound, Pap or HPV test, or blood tests such as haemoglobin, thyroid and sugar.
- A clear planYou leave knowing the likely cause, the treatment options and what to watch for.
- ReviewResults and response to treatment are reviewed, with screening reminders set for the future.
When to book a visit
- Periods come more often than every 21 days, less often than every 35 days, or have stopped for three months
- Periods are heavy enough to flood, pass large clots or last more than eight days
- Discharge that smells, itches or burns, or keeps coming back after treatment
- You are 25 or older and have never had a Pap smear or HPV test
- Your daughter is between 9 and 14 and you would like to discuss the HPV vaccine
- You are planning a pregnancy in the next few months
Warning signs - get same-day care
- Very heavy bleeding, soaking a pad every hour for two hours or more, or feeling faint
- Sudden, severe lower abdominal pain, especially on one side or with vomiting
- Pain or bleeding with a positive pregnancy test or a late period
- Fever with lower abdominal pain and abnormal discharge
- Any bleeding after menopause
Labour and emergency care are available 24 × 7. Call the hospital and come in directly.
Myths and facts
Myth: White discharge causes weakness and back pain.
Normal discharge does not cause weakness. Tiredness is more often due to anaemia, thyroid problems or poor sleep, and these are worth checking separately.
Myth: Unmarried girls should not see a gynecologist.
Adolescents and unmarried women have period, skin and hormone problems too. A visit is a conversation and, if needed, an abdominal scan, with no internal examination.
Myth: A Pap smear is only needed if you have symptoms.
Screening is meant for women with no symptoms. Its purpose is to find changes years before they could become cancer.
Myth: Heavy periods are just part of being a woman.
Bleeding that floods, clots heavily or causes anaemia is not something to put up with. Most causes are treatable with tablets or a short procedure.
Frequently asked questions
When should a girl first see a gynecologist?
There is no fixed age. A visit is useful if periods have not started by 15, if they are very heavy or painful, or if there are signs of PCOS. Many families also come when the daughter is 9 to 14 to discuss the HPV vaccine.
Is an internal examination always done at a gynecology visit?
No. It is done only when it helps with the diagnosis and only with your consent. Teenagers and unmarried women are usually examined with an abdominal scan instead.
How often should I have a Pap smear?
A common approach is every three years from age 25, and from 30 an HPV test, alone or with a Pap smear, every five years if results are normal. Your own schedule may differ if you have had abnormal results before.
Can I get a Pap smear during my periods?
It is better to book it at least a few days after your period finishes, because blood can make the sample harder to read. Avoid intercourse and vaginal creams for 48 hours before the test.
Is the HPV vaccine useful after marriage?
It is most effective before any exposure to HPV, but women up to their mid-twenties, and sometimes older, can still benefit. Whether it is worthwhile for you is discussed individually.
Why do my periods come twice a month?
Cycles shorter than 21 days can be due to hormonal changes, thyroid problems, polyps, fibroids or the years before menopause. A scan and a few blood tests usually find the cause.
What is the reason for white discharge with itching?
The commonest cause is a yeast infection (thrush), especially in hot weather, with diabetes or after antibiotics. Bacterial and sexually transmitted infections can look similar, so it is worth being examined rather than repeatedly self-treating.
Is it normal for periods to be irregular after 40?
Cycles often change in the years before menopause. However, heavy bleeding, bleeding between periods or after intercourse should still be checked, because polyps, fibroids and changes in the lining become more common with age.
Can I consult in Gujarati?
Yes. Consultations at Divine Women’s Hospital can be held in Gujarati, Hindi or English.